Is the Age of Cervical Cancer Diagnosis Changing Over Time? - 11/12/20

Doi : 10.1016/j.jogoh.2020.102040

Colette M. Gnade ^a,⁎ , Emily K. Hill ^b, Hannah E. Botkin ^c, Alison R. Hefel ^c, Hayley E. Hansen ^c, Kelsey A. Sheets ^c, Sarah L. Mott ^d, Abbey J. Hardy-Fairbanks ^a, Colleen K. Stockdale ^a
^a University of Iowa Hospitals and Clinics, Department of Obstetrics and Gynecology, Iowa City, IA, United States
^b University of Iowa Hospitals and Clinics, Department of Gynecologic Oncology, Iowa City, IA, United States
^c University of Iowa Carver College of Medicine, Iowa City, IA, United States
^d University of Iowa Holden Comprehensive Cancer Center, Iowa City, IA, United States

^⁎Corresponding author at: University of Iowa Hospitals and Clinics, Department of Obstetrics and Gynecology, 200 Hawkins Drive, 5 PFP, Iowa City, IA, 52242-1089, United States.University of Iowa Hospitals and ClinicsDepartment of Obstetrics and Gynecology200 Hawkins Drive5 PFPIowa CityIA52242-1089United States

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Highlights

•	Cervical cancer age at diagnosis has increased over the last 30 years.
•	Prevalence of cervical cancer in women over 65 years of age has not changed.
•	Almost 20% of women with cervical cancer over 65 inappropriately exited screening.

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Abstract

Objectives

The objective of this study was to determine if there has been an increase in the age of diagnosis of cervical cancer over time, specifically in the proportion of patients over 65 years old, given decreasing rates of hysterectomy.

Materials and Methods

A retrospective review of a single institution was conducted including cervical cancer patients seen between 1986 and 2016. Data included demographic variables including age of diagnosis, last cervical cancer screening, and cancer information. Cochran-Armitage test was used to assess temporal trends in the proportion of patients diagnosed over 65.

Results

A total of 1,019 patients with cervical cancer were reviewed, of whom 116 were over the age of 65. The age of diagnosis increased by 0.2 years per calendar year, with an average age of diagnosis of 43.7 years old in 1986 versus 49.5 years old in 2016 (p < 0.01). The proportion of patients diagnosed with cervical cancer over the age of 65 did not significantly differ over time (17.2% in 1986 vs. 14.8% in 2016, p = 0.39). 19.0% of women diagnosed with cervical cancer over the age of 65 developed cancer despite exiting screening appropriately.

Conclusions

In our cohort, the age of diagnosis of cervical cancer increased over time, however, there was no significant difference in the percentage of women diagnosed over the age of 65.

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Keywords : Cervical carcinoma, age, screening, pap smear, hysterectomy, papillomavirus infections