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Why cervical cancer cases are going down for some populations, but up for others

January is Cervical Cancer Awareness Month, and while there has been a decline in cases among young women, those 65 and older represent about 20% of new cases.

CLEVELAND — Recently, the American Cancer Society released its report indicating HPV-related cervical cancer among women ages 20-24 has declined. The reason they surmised was due to the HPV vaccine.

According to the CDC, that vaccine is available to both males and females ages 11-45, but another study found a more disturbing trend relating to older women and cervical cancer: Late-stage disease is on the rise. 

A study out of UC Davis of women diagnosed with cervical cancer finds that about 20% of new cases were in women 65 and older, and typically the older women were diagnosed with late-stage disease. Dr. Robert DeBernardo, section head for gynecologic oncology at Cleveland Clinic, says that could be due in part to the pandemic and the change in guidelines for pap smears.

Prior to the pandemic, women were told to get pap smears done annually. Now, it's every three years, and in some cases every five years.

"It's sort of hard to count by threes, and it's very easy to kind of lose track of when your pap smear was," DeBernardo told 3News. "Our guidelines are such that if it's done one way, then it's a slightly different screening protocol. I think that may be one of the issues that has led to an identification of more advanced cervix cancer that we're seeing in the United States."

Current guidelines from the American Cancer Society, the U.S. Preventive Services Task Force, and the American College of Obstetricians and Gynecologists all recommend that women 65 and over should no longer receive cervical cancer screenings if a series of prior tests was normal.

Cervical cancer is cancer of the cells in the cervix, which is the lower part of a woman's uterus. Early stages of cervical cancer don't usually involve symptoms and can be hard to detect, making the need for routine pap smears very important, because the test can identify any abnormal cells.

However, when symptoms do occur, they can include bleeding after sex, pelvic pain, and vaginal discharge that contains blood. DeBernardo says cervical cancer is preventable and is often the result of the virus HPV, a sexually transmitted infection.

Testing for that is equally as important; the same goes for the HPV vaccine.

"We developed a vaccine years ago," DeBernardo said. "There are several on the market; they are extremely effective at preventing cancer. In Australia, where uptakes of vaccines are high, they are seeing a decrease in the amount of cervix cancer in that country."

According to the CDC, roughly 13,000 new cases of cervical cancer are diagnosed every year in the United States, in addition to 4,000 deaths.


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