Screening for cancer of the cervix in elderly women.

A substantial proportion of women aged over 65 years has not been screened for cancer of the cervix and women in this age group are not included in current screening programmes. This policy is not supported by evidence from the natural history of preinvasive lesions. Since older women present with late disease (and therefore have a poor survival) 5-year survival rates adjusted for stage were used to estimate the reduction in number of deaths in women aged 20 years or older (during a 5-year period) if opportunistic screening were to identify more cases of cervical cancer at an earlier stage. 353 lives would be saved and women older than 65 would benefit most, with a 63% improvement in 5-year mortality. Thus, there is no reason to exclude women aged over 65 years from screening for cancer of the cervix.