"Alarming Number" of Cervical Cancer Diagnoses and Deaths in Women Over 65

The CDC recommends women stop screening for cervical cancer after 65, but a new study out of California shows a dramatic rise in both cervical cancers and deaths in that age group.

Those of you who’ve ready my book Ladyparts might understand why a new study out of California had me running to my computer this morning to get this information out to you as soon as possible. Quick background: in 2017, I was diagnosed with HPV 16/18 (the bad kind) and pre-cancer of the cervix. I then had my cervix removed and nearly died from vaginal cuff dehiscence three weeks later. The pre-cancerous cells in my cervix were discovered not through a pap smear—I’d had a hysterectomy and wasn’t told I still needed to still get pap smears—but because I’d begun bleeding. Copiously.

If I, a woman who writes about women’s health, was unaware that I still needed to get Pap smears after a hysterectomy, then the conclusions of this new study out of California—that women over 65 are getting and dying from cervical cancer at an alarming and much higher rate than younger women, and that “efforts should be made to better understand how the current screening paradigm is failing women of 65 years and older”—should come as no surprise. But it should also ring all of our alarm bells.

Some important facts to consider:

• A supracervical hysterectomy—the kind I had—means you still have a cervix, and it needs to get screened every year. But seriously? Don’t let them give you this kind of hysterectomy! If they’re going in there to yank out your uterus, might as well have them take out the cervix as well. In the absence of a uterus, you don’t need a cervix. The past guidelines—surprise, surprise—were wrong! The absence of a cervix does not interfere with sexual function. Plus the math is simple: No cervix = zero chance of cervical cancer.

• Pap smear screenings in post-menopausal women are less accurate in detecting adenocarcinoma, which is the kind of cervical cancer that is now on the rise when compared to squamous cell carcinoma.

• Older women are not receiving HPV testing, which is now the “gold standard” of cervical cancer screening as nearly all cases of cervical cancer are HPV-related.

• Menopause training in med schools is a joke. They’re not teaching it or teaching it poorly. My own (amazing!) gynecologist, Dr. Molly McBride, an expert in menopausal medicine, says everything she knows about menopause she had to learn on her own or teach herself by digging through the paltry studies available.

• The CDC does not recommend pap smears for women over 65—this is egregious!—and low-cost screenings of those without health insurance or means are only available to those who are 64 and under, which is even more egregious. (See screenshot from the CDC’s own website.)

All this to say, if you are 65 or older—which all of us will be one day—and you still have a cervix, FFS insist on a pap smear and HPV screenings every year. And if your doctor says, “Oh, sweetie, that’s not really necessary at your age,” just show them this article or print out this study and say, “Oh, sweetie. Yes it is.”