Women over the age of 65 may benefit from an HPV test to reduce the risk of cervical cancer, a study suggests.
In England, the NHS cervical screening program does not routinely offer screening to women aged 65 and over.
But some experts argue that there should be a “catch-up” program that encourages older women to be tested for high-risk forms of the human papillomavirus (HPV), which increase women’s risk of developing breast cancer. cervix.
A new study from Denmark compared more than 11,000 women who were offered an HPV recovery test with almost 33,400 women who were not invited to the test.
Among women invited for HPV testing, who were examined more closely for high-risk HPV, nearly four in 1,000 women were found to have precancerous cervical lesions that, without treatment, could develop into cervical cancer.
In England, the NHS cervical screening program does not routinely offer screening to women over the age of 65 (file photo of HPV testing kit)
The rate of these lesions was much higher than that of older women who were not invited to be tested for HPV, among whom only 0.3 women in 1,000 on average had lesions.
Women would need to be followed longer to see if those invited to an HPV test ended up with 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 could potentially improve cervical cancer prevention in women aged 65 and older than have never had an HPV test.”
Many older women in the UK may not have had an HPV test.
Standard smear tests, which only look for abnormal cells in the cervix, were the only form of screening available until HPV tests, which earlier identify people at increased risk of cervical cancer, were introduced in England in 2019.
In England, women aged 65 and over can request a test if they have never had an HPV test, but they will not be invited to one.
They will also continue to be tested after this age if they tested positive for high-risk HPV strains on 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 doesn’t happen routinely in this country.
These women had not been tested in the previous 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 detected 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 likely be if they had a cause for concern, such as postmenopausal bleeding.
The Danish researchers suggest that women who have not been screened in midlife, who have had one or no smear test between the ages of 50 and 64, would benefit most from HPV recovery 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 using cells taken from the cervix during a standard smear test.
The researchers offered the women the option of seeing a doctor for testing or collecting a vaginal screening sample at home.
They found that the self-test kit was almost twice as popular among women who had had one or no smear test between the ages of 50 and 64, compared to those who had had more tests.
In England, women aged 65 and over can request a test if they have never had an HPV test, but they will not be invited to one (file photo)
Finding new ways to encourage women to get cervical screening, where they have been reluctant in the past, is especially important in the UK.
An earlier study found that women who had not been screened since age 50 were almost six times more likely to develop cervical cancer after age 65.
Samantha Dixon, chief executive of Jo’s Cervical Cancer Trust, said (SUBS – please maintain): ‘Accepting his invitation for cervical screening at any age can help stop cancer before it starts.
‘If you’ve never been, or haven’t been since you turned 50, you can still book a screening when you’re over 65.
‘Talk to your GP if you experience any symptoms of cervical cancer.’
A spokesman 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 25-64, the benefits of cervical cancer screening outweigh the damage it can cause.”
‘If you are 65 or over and have never had a cervical exam, or haven’t had a cervical exam since age 50, you can ask your GP for a test.
‘To address the challenges of people keeping their screening appointments, two studies have been set up to investigate self-sample testing.
“This allows people to take a sample in the comfort of their home, which helps reduce concerns about the procedure and allows people who cannot easily travel to be tested.
“The findings will inform any recommendations from the UK National Selection Committee.”
