Women over age 65 could benefit from an HPV test to reduce their risk of cervical cancer, a study suggests.
In England, the NHS cervical screening program does not routinely provide screening for women aged 65 and over.
But some experts believe there should be a “catch-up program” inviting older women to be tested for high-risk forms of human papillomavirus (HPV) – which increase women’s risk of developing cervical cancer.
A new study conducted in Denmark compared more than 11,000 women who were offered such a catch-up HPV test with nearly 33,400 women who were not invited for the test.
Of the women who were invited for the HPV test and examined more closely to see if they were at high risk for HPV, nearly four in 1,000 women were found to have precancerous cervical lesions that, if left untreated, could become cervical cancer.
In England, the NHS cervical screening program does not routinely offer screening for women aged 65 and over (HPV screening kit file photo)
The rate of these lesions was much higher than in older women who were not invited for an HPV test, of whom, on average, only 0.3 in 1,000 women were found to have lesions.
The women should be followed up longer to see if those invited for HPV testing would have a lower rate of cervical cancer as a result (SUBS – please hold).
But Dr Mette Tranberg, who led the study from Randers Regional Hospital in Denmark, said: ‘A catch-up HPV screening test could potentially improve cervical cancer prevention in women aged 65 and over who have never had an HPV test. undergo.’
Many older women in the UK may have missed an HPV test.
Standard Pap smears, which look only for abnormal cells in the cervix, were the only form of screening available until HPV testing was introduced in England in 2019, which identified those at higher risk of cervical cancer earlier.
In England, women aged 65 and over can apply for a screening test if they have never had an HPV test, but are not invited to do so.
They will continue to be tested beyond this age if they were positive for the high-risk strains of HPV at their last screening, or had abnormal results.
But the new study looked at women ages 65 to 69 who were specifically invited for an HPV test, which is not routinely done in this country.
These women had not been screened in the past five and a half years or more and had not had an HPV test after age 60.
The results, published in the journal PLOS Medicine, show a more than 10 times higher rate of cervical lesions in this group compared to women of the same age receiving standard cervical care in Denmark.
Standard care meant they could request an HPV test, but this would be more likely if they had cause for concern, such as postmenopausal bleeding.
The Danish researchers suggest that women who missed screening in middle age, with one or no Pap smears between the ages of 50 and 64, would benefit most from catch-up HPV testing.
The study also identifies a way to try to get more older women, who may be concerned about embarrassment or pain, to opt for an HPV test, which is done with cells removed from the cervix during a standard Pap smear.
Researchers offered women the choice of seeing a doctor for the test or collecting a vaginal screening sample themselves at home.
They found that the self-test kit was nearly twice as popular among women who had one or no Pap smears between the ages of 50 and 64, compared to those who had more screening.
In England, women aged 65 and over can apply for a screening test if they have never had an HPV test, but are not invited (stock photo)
Finding new ways to encourage women to undergo cervical screening, when they have been reluctant in the past, is particularly important in the UK.
A previous study found that women who have not been screened since age 50 are almost six times more likely to develop cervical cancer than they are at age 65.
Samantha Dixon, managing director of Jo’s Cervical Cancer Trust, said (SUBS – please hold): ‘If you accept your cervical screening invitation at any age, you can help prevent cancer before it starts.
‘If you’ve never been, or haven’t been since you were 50, if you’re over 65 you can still book a screening.
“Speak to your GP if you experience symptoms of cervical cancer.”
A spokesperson for the Department of Health and Social Care said: ‘The UK National Screening Committee makes evidence-based decisions and we know that for people aged 25 to 64, the benefits of cervical cancer screening outweigh the harm it can cause.
‘If you’re 65 or older and have never had a cervical exam, or haven’t had a cervical exam since you were 50, you can ask your GP for a test.
?To address the challenges of people attending their screening appointments, two studies have been set up to examine self-sample testing.
?This allows people to take a sample in the comfort of their own homes, reducing concerns about the procedure and allowing people who cannot easily travel to be screened.
‘Findings will inform recommendations from the UK National Screening Committee.’