Pap Smears, Elderly Women, and Medicare

The burden of prevention: downstream consequences of Pap smear testing in the elderly

“…[34][35][36][37] Women never screened, who have the highest incidence of and mortality from cervical cancer and the lowest likelihood of future screening 38 , bene t the most from screening. 6,32,39 It is at these women that public health campaigns to lower cervical cancer incidence and mortality are aimed. 40 Little effort, however, has been made to ensure that women screened through Medicare are those who have never been previously screened, rather than those with a lifetime of previous normal Pap smears.…”

“…While recommendations supporting Pap smear screening are based on strong evidence from observational studies, these studies included few women over 65. 32,33 Although cervical cancer mortality climbs after age 65, any bene t of screening is expected to decline markedly with age due to increases in competing causes of death and long delays in the realization of bene ts of screening. Because the bene ts of cervical cancer screening in the elderly are so uncertain, a realistic assessment of the potential harms is essential.…”