Objectives In 2003 the USPSTF recommended discontinuing cervical cancer screening at age 65 in low risk adequately screened women. We aim to evaluate trends in cervical cancer incidence and screening in United States Black and White women over age 65.
Methods Data were obtained from United States Cancer Statistics (USCS) from 2001 to 2017 and from the Behavioral Risk Factor Surveillance System (BRFSS). SEER*Stat and Joinpoint regression program were used for statistical analyses.
Results Using USCS data, we evaluated differences in cervical cancer incidence by race and age. We found the highest incidence in Blacks aged 65 to 69 years at 17.6/100,000, compared to 15.0/100,000 in Whites aged 40–44 years. of note, the incidence among Blacks over age 69 remained high at 13.9–17.5/100,000 whereas the incidence in Whites decreased steadily after peaking in 40–44 year-olds. Using BRFSS data, we evaluated patterns in screening, and demonstrated that 34.7% of Blacks aged 65 and older had never been screened compared to 21.5% of Whites. of those screened, 19.8% of Blacks aged 65–69 years were non-adherent to guidelines (no Pap in five or more years) and the rate of non-compliance increased 5.2% per year over our study period (p<0.001).
Conclusions Over one third of Blacks aged 65 and older never underwent cervical cancer screening, and the rate of non-compliant screening is increasing. With the highest incidence of cervical cancer in Blacks seen in this age group, the role of individualized cervical cancer screening guidelines should be considered.
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