It is a misconception that women over the age of 65 do not need regular pap smears or annual pelvic exams. One recent study conducted in San Francisco found that women over the age of 65 were less likely to have had a pap smear during the past 3 years and less likely to have seen a gynecologist when compared with younger women. This is alarming considering that women between the ages of 60 – 70 are at the highest risk for certain types of cancers, including ovarian cancer and uterine cancer. In order to protect themselves and to detect any issues early on, women 65 and older should still be getting regular gynecological exams and pap tests.
Cervical cancer and other cancers of the female reproductive system often cause no symptoms, which is why screening tests and regular physical exams are the only way to detect them. Despite knowing this, cancer screening guidelines for women seem controversial at best, especially for women aged 65 and older.
The American Cancer Society suggests that, for women over the age of 65, only those who have had previous abnormal results should have regular pap smears – those who have had regular screenings with normal results do not need to be screened for cervical cancer. This means that these women would no longer be screened after three consecutive negative pap tests. However, even if women and their doctors decide that they no longer need regular pap smears, they should still seek a regularly scheduled pelvic exam.
What Research Suggests
The truth is, there is no age limit on cervical cancer and other cancers of the female reproductive system. In fact, according to research out of the University of Alabama at Birmingham, as many as 20% of cervical cancer cases are in women aged 65 and older, with an even higher rate among women aged 70 – 79.
“The media is giving women inaccurate information about their health,” says Barbara Schulz, M.D., an Obstetrician/Gynecologist with the Torrance Memorial Physician Network’s Women’s Center. “Just because you reach a milestone age doesn’t mean you’re immune to certain illnesses, no matter what you read in the newspaper or on the Internet.”
Another study conducted in 2018 found that one in five cases of cervical cancer is missed when a woman stops getting screened after age 65.
Not having annual pelvic exams can be similarly disastrous. “Last year we had two women in their 80’s with uterine cancer. They were told they didn’t need a pelvic exam anymore,” explains Dr. Schulz. “It’s unfortunate because uterine cancer is one of the most curable cancers that you can get when it’s caught early.”
What Medicare Covers
Women over 65 do have the option to continue being screened for these cancers: both pelvic exams and pap smear tests are covered under Medicare Part B. The services are free to beneficiaries as long as their healthcare provider accepts Medicare. Medicare Part B covers a pap smear once every two years, and possibly once every year for women who are at high risk. Beneficiaries pay nothing for pap smears, pelvic exams, or breast exams, unless their doctor recommends more frequent tests or additional services. Only then will co-pays and other out-of-pocket costs be applicable.
Many women over the age of 65 are not offered regular pap smears if their past results have been negative, despite research showing that they are at a higher risk of cervical cancer than younger women. For this reason, all women aged 65 and older should continue to be screened regularly. It is also important that they continue to see their gynecologist for regular pelvic exams. Cancer screening is a free preventive service that is covered by Medicare, so all women should take advantage of it – and possibly catch any signs of cancer early on.