Is there a benefit to continue pap smear screening for cervical cancer after 65 years of age? A retrospective study on 53,644 women

Background. One third of cervical cancers are discovered after age 65. French guidelines allow women to cease having cervical pap smears at age 65, providing they have had a minimum of two consecutive negative smears. Aim. To study the frequency of pathological smears in the group of women aged over 65 with a normal and sufficient cytological follow-up, according to the guidelines. To analyze the smear results and the former follow-up of this population to determine whether there is an interest to continue the smear screening after age 65. Methods. This is a retrospective multicenter study based on collecting data from three pathology laboratories of the region Rhone-Alpes. We study a population of women 65 and older with smears that have been made between 2004 and 2008. Results. Precancerous lesions and cervical cancer can be discovered after age 65 despite an adequate former follow-up. The rate of these women for having a pathological smear is 14,2%, including 1,2% with cytological abnormalities in favour of cancer. Conclusion. These results show that there is interest to continue the smear tests after age 65 at least, while considering medical and financial issues of a reasonable screening strategy