Gynecological Care of Elderly Women:  Another Look at Papanicolaou Smear Testing

Jeanne Mandelblatt, MD; Irene Gopaul, FNP; Marta Wistreich, MD
JAMA. 1986;256(3):367-371. doi:10.1001/jama.1986.03380030069030.
Text Size: A A A
Published online

Mortality from cervical cancer is decreasing in countries where aggressive Papanicolaou smear screening programs are in place. However, elderly women are likely to be lifelong nonusers or underusers of Papanicolaou screening, and mortality has not declined for older women. Many studies have noted that nonparticipants in Papanicolaou screening have a 2.7 to four times greater incidence of cervical cancer when they are screened compared with women who have been screened at least once. Gynecological screening was offered to 1542 elderly women in a primary care setting; 75% of the women had not had regular prior screening and 25% had never been screened. Half of these women chose to participate in our screening program. An overall prevalence rate of 13.5 per 1000 abnormal Papanicolaou smears (95% confidence interval, 5.6 to 21.4) was noted in the group. Age, race, prior screening history, and abnormal gynecological symptoms failed to predict the women who would have abnormal Papanicolaou smears. Our results suggest that cervical cancer screening should continue beyond 65 years of age if women have not received regular prior screening.

(JAMA 1986;256:367-371)


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.