Cervical Screening needs over 65…….?

As older women do not need contraception they are less likely to use a condom.
I had HPV 16 at 63 followed by one clear test a year later. I went for a smear test at 65 but they would not do it as I had passed the cut off age. I had a private test which just came back HPV 16 & 18 clear but ‘dangerous type of HPV found”.
I am trying to get a smear test to check it out. I am really worried that because I am over 65 and off the system.
Waiting on GP surgery for advice. I can’t be the only older person in this situation.

There was a history of cc in our family so my mum felt the same as yourself when she was told screening would no long be offered, she had also been requesting a hysterectomy, so it would never be an issue, was refused due to no medical need. On the first issue she just told the gp she had been having bleeds and as past menopause they did a smear as symptoms were present, then at 67, she developed a large mass in her abdomen /uterus and she was admitted for a full hysterectomy, turned out to be benign, but her argument was that if she had been given when she requested, she would not have had to go thru the worry and stress of an emergency hysterectomy at 67. But as to your request do not give up on getting your Dr to do if you are worried.

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Keep pushing your GP. If you’ve got high risk HPV you should have regular checks, regardless of your age. There may have been a time when reaching retirement age meant life was practically over and there was little point in worrying about the possibilities of a slow growing cancer, but that is faintly ridiculous now. At 66 (I will be 65 in the spring) you should be looking forward to a good 20 years more of life and you will sure enjoy it better without cervical cancer…

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Thank you for understanding the stressful issue. I strongly feel the age for stopping smear tests needs raising to 70.
I’m going to send my doctor a copy of the results and keep asking for a smear test to check it out until it’s hopefully gone. I’ve no idea why it’s come back or why it appears a different strain.

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Hi 66yrsyoung

You are not alone in your view. There have been some reports suggesting that smear tests should be routinely offered to women over the age of 65y. The following copy and paste article entitled ‘Cervical cancer screening upper age limits could move to 75 in light of new study’ is from a website ‘pulsetodat.co.uk’; it was published November 2018 - I don’t know if there has been any progress.

The committee in charge of health screening programmes is going to review findings of a new study that recommends increasing the upper age limit for regular smear tests to 75.

Researchers modelled the benefits of cervical screening in older women, and found that increasing the upper age limit led to ‘decreases in cancer risk later in life’.

Currently, the NHS carries out cervical cancer screening in women up to 65 years, but the UK National Screening Committee said it will review these new findings and ‘consider its results’.

The study, published in The Lancet Oncology assessed the impacts of screening older women, comparing different screening tests – cytology (smear) and HPV – and projecting the risks for women who stopped screening at different ages.

They found that ‘increasing the age at which women stopped cytology screening to 75 years led to incremental decreases in cancer risk later in life’, with a 70 year-old woman reducing her average remaining lifetime risk from one in 588 if she stopped screening, to one in 1,206 if she had a negative cytology test.

The risk dropped to one in 6,525 if she had a negative HPV test, and one in 9,550 if she had a negative co-test for cytology and HPV.

The paper said: ‘We found that cervical cancers in later life, which might have been underestimated by policy makers because registry data generally do not remove women with hysterectomies from denominators, could be prevented in later life with cytology screening up to age 75 years.’

Senior lecturer and honorary consultant gynaecological oncologist at the University of Manchester Dr Emma Crosbie said: ‘Current UK practice is to stop cervical screening at age 65 if the exit screen is negative. However we know that the peak age incidence of cervical cancer is bimodal, the highest peak at age 30-34 years and a second peak in women aged 70-74 years.’

She added: ‘Continuing to screen women into their 70s can reduce risk further by identifying and treating premalignant disease of the cervix, although at a diminishing rate of return. These results make a strong argument for continuing screening beyond age 65 years.’

UK National Screening Committee director of programmes Professor Anne Mackie said: ‘The UK’s independent expert screening committee looks forward to reviewing the findings of this new international research and will consider its results.’

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Correction: first paragraph of my comment above.

website is ‘pulsetoday.co.uk’

x

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I totally agree with the article that smear tests should be available to over 65’s, especially when a ‘dangerous type of HPV’ has been found.

My GP surgery has tried to reassure me that as there were no cell changes in my last smear and no trace of the original HPV16 I should be alright and to contact them straight away if I have any bleeding or lower back pain.

This leaves me with a positive private HPV test (tho it does not specify which type just HPV) it does say HPV 16&18 NOT found but a dangerous type of HPV was found.

As I am now 66 the NHS is unable to process a test. I guess I will have to get a private smear test (tho I think they are about £400) in a year or so.

Thanks for letting me put this out there. It’s still concerning tho I feel a bit more rational after talking about it on here and to the surgery.

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I really think you should press your GP. I am 74 years old and have not been sexually active for some years, have never had an abnormal smear and had my last at 65. In August I was diagnosed with 1b2 squamous cell carcinoma and had a radical hysterectomy with lymph node removal. I said to my Consultant that I didn’t know women of my age got cervical cancer and he said that HPV can stay in your system for years without you knowing it and then suddenly something sets it off. I haven’t posted before but I have read all the posts which have really helped me. I don’t know how you younger women cope with all this, at least I have had my children and been through the menopause, but for those that haven’t, you are remarkable and my heart goes out to you all. I have had some really dark moments thinking why bother having the surgery at my age! I am only now beginning to feel more like myself but in the back of my mind I wonder whether it will come back. Luckily all the pathology results were clear so I didn’t have to have any more treatment, but still you wonder…. My 3 month check up is due end of December. Thank you for listening to me rambling on.

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Hi Jay
You are not rambling on and it is worth having surgery at your age. HPV comes as a shock at any age and I think the fear of reccurence is normal. At least your cancer seems to have been caught at an early stage - Hope your results are all clear at the end of December. I can recommend Jo’s helpline if you have a wobble. I personally think screening should continue over the age of 65. Also I think more women over the age of 50 need to be made aware of the fact that HPV can lie dormant for many years. Lots of women over 50 do not attend screening in the mistaken belief that they no longer need it if they are no longer sexually active. I also feel for the younger generation going through this when they have small children or are in their 20s. It’s very positive that the HPV vaccine has had a high success rate for the youngest generations. I feel also that it is very sad that low and middle income countries have such high mortality rates because of the lack of vaccines and screening in some countries. Big hugs and welcome to the forum A x

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Hi Jay, thank you for writing your experience and getting this out there. I am so sorry you have had to go through this when it could’ve been found and treated much earlier. I am glad you got the treatment you needed and are feeling better from your operation.
Women like us need testing after 65. I know HPV is a slow developer, often over years but we shouldn’t be abandoned with HPV to live with that risk.
My GP surgery is overwhelmed right now and apart from writing him a letter, I have no idea how to push my doctor for a test! I have been told the NHS will not do one over 65.
All the best. Jay. I hope all goes well for you. Let me know how you get on! Good luck!

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Hi 66yrsyoung

It’s always worth trying but it’s my understanding that even if your GP agreed to do a smear for you it wouldn’t be processed by the laboratory if it falls outside the guidelines of the NHS cervical screening programme. Might be worth checking this with ‘ask the expert’ service on this website.

I’m not an expert but I suspect that it’s a case of waiting for a change in NHS policy, petitioning for a change or going private.

x

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Hi Jazza, I’ve come to that conclusion too and trying to get over the inbred ‘don’t want to bother them’ ostrich excuses not to.

Thank you, I didn’t know about the ‘ask the expert’ service. That’s great, well worth a try and I’ll post what they say. thanks again, x

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Hi Jay

I’m sorry you were confronted with a diagnosis of cc. I was diagnosed age 60y in 2017 albeit in my case I’d elected to stop getting smear tests age 50y.

When I was going through my treatment there were 4 or 5 other cc patients one of whom was over the age of 65y. It started me wondering just how many 65+ ladies are having to endure a preventable cc.

Whilst I’d agree it’s sadder when a young woman is diagnosed with cc it has to be absolutely worth preventing cc in older women for the sake of a 5 minute smear test and possibly some relatively straightforward treatment such as LLETZ or maybe a simple hysterectomy (versus a radical hysterectomy which includes lymph node removal). A woman in her mid 60s/70s can reasonably expect to live another 20 -30 years which is a long time to be coping with what can be debilitating side effects of cancer treatment.

x

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Thanks for all your comments ladies. It’s comforting to know that there are people on this site that know exactly how you feel. When family and friends think you are over it and coping well, you don’t really want to burst their bubble and start going on about how you really feel, rather than telling them what they want to hear!

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