A new study shows that the number of women aged 65 and older dying from cervical cancer is “alarming”

Nearly one-fifth of new cervical cancers diagnosed between 2009 and 2018 were in women 65 and older, according to a new study from the University of California, Davis. But experts are concerned that more older women (71 percent) have advanced cancers than younger women (48 percent), which corresponds to lower survival rates that only get worse with age, according to the study.

In general, if cervical cancer is diagnosed after it has spread to nearby tissues, organs or lymph nodes, the five-year relative survival rate is 59 percent, according to the National Cancer Institute (NCI). However, the study found that women over 65 had a lower late-stage five-year relative survival rate of 23.2 to 36.8 percent compared to women under 65 (41.5 to 51.5 percent). (By comparison, the five-year relative survival rate was 92 percent when cervical cancer was diagnosed at an early stage, according to the NCI.)

Current screening guidelines from the American Cancer Society (ACS) recommend that people over the age of 65 who have been screened for cervical cancer within the past 25 years with normal results and have tested negative for cervical cancer in the 10 years prior to age 65 should not be screened for cervical cancer. Once screening is discontinued, please note the guidelines and screening should not be started again.

However, as this study reveals, cervical cancer risk does not simply go away at age 65.

Julianne Cooley, lead author of the study and a senior statistician at the University of California, Davis, told Yahoo Life that the American Cancer Society predicts 13,960 women in the United States will be diagnosed with cervical cancer in 2023, “20 percent of whom will be older than 65,” she said.

Cooley said the findings are “very concerning” because “cervical cancer is preventable through screening, and no one dies from the disease.”

Dr. Connie Liu Trimble, professor of obstetrics and gynecology at Johns Hopkins University School of Medicine, agreed, calling it “ironic. She told Yahoo Lifestyle, “This should not be happening in this day and age.”

So what can older women do to protect their health? Here’s what the experts have to say.

What are the causes of cervical cancer?

Almost all cervical cancers are caused by HPV (human papillomavirus), an extremely common virus. According to statistics, approximately 13 million Americans are infected with HPV each year by the Centers for Disease Control and Prevention (CDC).

HPV is transmitted through vaginal intercourse, anal and oral sex, and through skin-to-skin contact with the genitals of an infected person in the following ways “If you’ve had sex, you’ve been exposed to HPV – period,” Trimble said.

There are more than 200 types of HPV, including low-risk types that can cause warts, and 14 high-risk types (specifically HPV16 and HPV18) that can cause several cancers – not just cervical, but also vaginal, vulvar, penile, anal and back-of-throat cancers, according to the CDC.

In most cases, “the immune system can clear HPV, but the body’s ability to clear it decreases over time,” Dr. Renata Urban, a gynecologic oncologist at UW Medicine, told Yahoo Lifestyle.

But in some cases, HPV persists for several years – Trimble says it can take “10 to 15 years for a precancerous lesion to become cancerous,” which causes abnormal changes in the cells of the cervix that lead to cancer.

Are there gaps in current screening guidelines for older women?

Although more than 20 percent of cervical cancer cases occur in women over age 65, these cancers “rarely occur” in people who receive regular cervical cancer screenings before age 65, Sarah Diemert, a nurse practitioner and director of integration and evaluation of medical standards for the Planned Parenthood Federation of America, told Yahoo Lifestyle.

Because it can take a decade or more for HPV-infected cervical cells to become cancerous, combined with the increase in late-stage cervical cancer in this older population, Urban said, it “means women aren’t getting the proper screenings” and it’s not clear why – -patients not going to the doctor and missing years of cervical cancer screening, or doctors not screening? Or does screening need to be extended beyond age 65?

Cooley said her findings do not allow her to determine whether screening should continue beyond age 65 “because we don’t have data on whether women diagnosed with cervical cancer over age 65 were screened before age 65.”

However, she said, “We do know that as many as 23 percent of women over age 18 are not screened for cervical cancer in a timely manner, and many do not follow up on the results of irregular screenings. Therefore, screening guidelines may be adequate, but older women are not following screening guidelines until age 65, leaving them vulnerable to a diagnosis of late-stage cervical cancer.”

Older women may also underestimate their risk. diemert notes that cervical cancer is most common in women aged 35 to 44, with an average age of 50 at the time of diagnosis. “Many older women don’t realize that the risk of developing cervical cancer remains as they age,” she said.

How to treat advanced cervical cancer?

Treatment is usually a combination of chemotherapy and radiation therapy, as well as a specialized therapy called brachytherapy, in which a radiation source is placed intravaginally, according to the ACS.

However, Trimble said, treating advanced cervical cancer is “really difficult,” especially in older patients. This can affect kidney function and may affect their ability to receive the most common forms of radiation therapy. In addition, some side effects may include loose stools or diarrhea, but older women may be more prone to dehydration and fatigue, “so these side effects may hit them harder.

What can older women do to protect their health?

“These findings underscore the need for anyone with a cervix to be screened regularly for cervical cancer and other types of cancer,” Diemert said.

For Cooley, she says it’s important to determine whether a woman meets screening guidelines before she turns 65 before stopping regular screening. “If older women are not getting regular screenings before age 65, they should schedule a catch-up test as soon as possible,” she says. trimble adds that if your primary care doctor doesn’t or won’t do cervical cancer screenings, you should find a gynecologist who does.

While the guidelines recommend that most people stop cervical cancer screening by age 65, in some cases screening is recommended after age 65 – that is, for people at higher risk, including those “with a history of high cervical lesions or cancer who have not been adequately screened and whose mothers took a drug called dienestrol (DES) during pregnancy or in people with weakened immune systems,” Diemert said, adding that people should discuss with their health care providers how often and until what age they should be screened.

It’s also important to see your doctor if you have any symptoms of cervical cancer, Cooley noted. Early symptoms include vaginal bleeding after intercourse, during or after menopause, and pelvic pain or painful intercourse, according to the NCI. Late symptoms include difficult or painful bowel movements, rectal bleeding during bowel movements, difficult or painful urination, and back pain.

Seniors should be aware of the general risks of cervical cancer and their own personal risks, Diemert said. These risks include a personal history of cervical, vaginal or vulvar dysplasia (abnormal cell growth); a family history of cervical cancer; smoking; and other infections, including chlamydia.

The good news is that if a precancerous lesion is found during screening, it can be treated, Diemert says, “to prevent it from becoming cervical cancer.”