Is It Time to Revise Cervical Cancer Screening Guidelines?

INTRODUCTION: In our retrospective study, we tried to determine whether cervical smear screening is necessary in patients over 65 years of age by comparing the cytological and histological results of patients over 65 years of age.
METHODS: A retrospective review of the cytological and histological results of 3465 patients over the age of 65 who underwent cervical cytology between September 2017 and September 2022 was conducted.
RESULTS: It was established that 547 of the 3,361 patients with normal Pap smear results had irregular screening follow-ups, while 2,814 patients were undergoing regular follow-ups following the screening program. Of the 104 patients with abnormal Pap smear results, 54 had irregular follow-ups and 50 had regular screening. Among the 601 patients aged 65 and above who did not undergo regular cervical screening, 8.98% exhibited abnormal smear results and 3.16% displayed abnormal histological findings.When abnormal Pap-Smear results and abnormal biopsy results were analyzed, it was found to be significantly higher in women over 65 years of age without regular follow-up. (p<0.001),(p<0.05)
DISCUSSION AND CONCLUSION: Significant differences were observed in the frequency of abnormal smear results and the severity of diagnosis in women over 65 years of age who were followed up irregularly in line with the cervical cancer screening program compared to those who were followed up regularly. The results of our study indicate that the screening cut-off age should be revised for patients with irregular cervical screening to reduce the incidence of cervical cancer and precursor lesions.