A recent study suggests that women over the age of 65 could benefit from undergoing an HPV test to reduce their risk of developing cervical cancer. In England, the NHS cervical screening program does not typically offer screening to women aged 65 and older. However, some experts argue that there should be a “catch-up” program that invites older women to be tested for high-risk forms of HPV, which can increase their risk of cervical cancer.
To explore this idea further, a study was conducted in Denmark involving over 11,000 women who were offered a catch-up HPV test and almost 33,400 women who were not invited for the test. Among the women who were invited for the HPV test and subsequently examined for high-risk HPV, it was found that nearly four women in every 1,000 had pre-cancerous cervical lesions. If left untreated, these lesions could progress to cervical cancer. This rate was significantly higher than in older women who were not invited for an HPV test, where only 0.3 women in every 1,000 on average had such lesions.
It is important to note that further follow-up is needed to determine if those who were invited for an HPV test experienced a lower rate of cervical cancer. Dr. Mette Tranberg, the lead researcher from Randers Regional Hospital in Denmark, believes that a catch-up HPV screening test could potentially improve cervical cancer prevention in women aged 65 years and older who have never undergone an HPV test.
Many older women in the UK may have missed out on HPV testing. Until the introduction of HPV tests in England in 2019, standard smear tests that only detect abnormal cells in the cervix were the only form of screening available. Women aged 65 and older in England can request a screening test if they have never had an HPV test, but they will not be automatically invited for one. However, the Danish study focused specifically on women aged 65 to 69 who were invited for an HPV test, which is not a routine practice in this country. These women had not been screened in the previous five and a half years or more and had not received an HPV test after the age of 60.
The results of the study, published in the journal PLOS Medicine, revealed over a ten times higher rate of cervical lesions in this group compared to women of the same age receiving standard cervical care in Denmark. Standard care involved the option to request an HPV test, typically in cases where there was a cause for concern such as post-menopausal bleeding. The researchers from Denmark suggest that catch-up HPV tests would be most beneficial for women who have missed out on screening in their middle-age, having one or no smear tests between the ages of 50 and 64.
The study also identified a potential way to encourage more older women to opt for an HPV test. Researchers offered women the choice of either seeing a doctor for the test or collecting a vaginal screening sample themselves at home. It was found that the self-testing kit was nearly twice as popular among women who had one or no smear tests between the ages of 50 and 64, compared to those who had more screenings.
Encouraging women to undergo cervical screening, especially those who have been reluctant in the past, is crucial in the UK. A previous study revealed that women who were not screened since the age of 50 were nearly six times more likely to develop cervical cancer over the age of 65. Samantha Dixon, the chief executive of Jo’s Cervical Cancer Trust, emphasized the importance of taking up the invitation for cervical screening at any age to prevent cancer.
For women aged 65 and older in the UK who have never had an HPV test or have not been screened since the age of 50, they can request a test from their GP. To address the challenges of people attending their screening appointments, two studies have been initiated to investigate self-sample testing. This approach allows individuals to take a sample at home, reducing concerns about the procedure and accommodating those who have difficulty traveling. The findings from these studies will inform any recommendations from the UK National Screening Committee.
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