OBJECTIVES : Evaluate the burden of cervical cancer in women 65 and over and screening patterns leading to and after age 65.

METHODS : Burden of cervical cancer in women 65 and over and screening patterns in the US was evaluated using data published by the NIH’s Surveillance, Epidemiology, and End Results (SEER) program and IBM® MarketScan® Claims-Electronic Health Records (EHR) Databases, which includes administrative medical and pharmacy claims data and clinical and laboratory information found in electronic health records. The look back period to evaluate screening patterns were 10 years before cervical cancer diagnosis from 2000 to 2017.

RESULTS : According to the SEER, approximately 1 in 5 newly diagnosed cervical cancers are found in women 65 and older. Among women aged 30 to 59 years, 59.3% of commercially insured and 31.4% of Medicaid insured women received two or more Pap tests. In IBM claims-EHR databases, 1,054 women 65 and older were newly diagnosed with cervical cancer. Of these, 70% were insured for an average of 5.9 years before their cancer diagnosis. 61% of the women had evidence of prior screening, 44% had ≥1 screening in the past 5 years and 33% had ≥1 screening in the past 3 years. Among one-third (39%) who did not have a prior screening, 83% had ≥1 physician visit in the year before their cancer diagnosis.

CONCLUSIONS : Approximately 20% of newly diagnosed cervical cancer cases are found in women 65 and older. Patterns of cervical cancer screening in women 50 to 65 is suboptimal thus failing to identify precancerous lesions. Only two-third of newly diagnosed women had a prior screening while among the remaining one-third without prior screening, 85% had ≥1 encounter with a healthcare provider prior to cancer diagnosis. Underscreening before age 65 highlights the need for increased surveillance in past 65 years of age.