Cervical Cancer Deaths Said Highest for Elderly

Elderly women appear to have higher death rates from cervical cancer than younger women, and screening them for the disease “is relatively cost effective for the number of lives saved,” according to a federal report released Tuesday.

“Cervical cancer screening with the Pap smear test is a preventive service that is routinely performed on women of all ages, but that is much less common among elderly than among younger women,” said a report issued by the Office of Technology Assessment, a nonpartisan analytical agency that serves Congress.

Beginning in July, Medicare will pay for Pap tests if a woman has not received a Medicare-covered Pap test within the previous three years.

Cancer experts praised the report, saying it strengthened their arguments that women of all ages should be regularly screened. “It reinforces our own guidelines, which call for Pap testing as long as a woman is alive,” said Joann Schellenbach, a spokeswoman for the American Cancer Society.

Cervical cancer, which is typically slow-growing and highly-curable if detected early, occurs on the cervix--the neck or lower part of the uterus. There are about 13,000 new cases annually, according to the American Cancer Society, and an estimated 6,000 women are expected to die of the disease in 1990.

It was once a major cancer killer of women, but the death rate from this type of cancer has decreased more than 70% during the last 40 years, largely as a result of regular checkups and the introduction of the Pap test, a simple procedure in which a sample of cells is taken from the cervix and body of the uterus and examined for abnormalities under a microscope.

One-fourth of the new cases of invasive cervical cancer occur in women age 65 and older, and 1,867 elderly women died of this disease in 1986, the OTA report said. More than 43% of deaths from cervical cancer occur in women 65 or older, the report said.

Across all ages, women at greatest risk for cervical cancer are those who are poor, are nonwhite, were young at the age of first sexual intercourse, have had multiple sexual partners and/or smoke, the report said.

Schellenbach said that one reason death rates from cervical cancer in older women were higher was because “they don’t get screened with the high frequency rate” that younger women do.