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Published: 24 April 2024

New research highlights importance of cervical screening for women post-menopause

Dr Lucy Bolger, Specialist Registrar in Obstetrics & Gynaecology, Ireland South Women & Infants Directorate

We completed a review of women referred to colposcopy who were postmenopausal to better understand the reasons for referrals and the diagnoses made at colposcopy.

Why we did the research

While evidence supports continuing to offer cervical screening to women post-menopause, it does present challenges, and attendance rates are lower in this population. Vaginal dryness and irritation experienced by many women post-menopause can lead to discomfort during a cervical screening test. The cervix can also be more difficult to assess at colposcopy due to the impact of low oestrogen on the cells of the cervix post-menopause.

How we did it

We reviewed 276 consecutive referrals of postmenopausal women who had their first visit to Kerry colposcopy service between 2020 and 2023. We collected data on:

  • the reason for referral
  • the diagnosis made at the colposcopy clinic
  • the results of biopsies taken
  • some background demographic data.

What we found

  • 39 women were referred due to difficulty getting a cervical screening test with their GP.
  • Of the 237 women who were referred for colposcopy, the most common reasons for referral were HPV positive with low-grade abnormal cells, and HPV positive on two consecutive tests with no abnormal cells.
  • 120 women had biopsies at their first visit and 66% were normal.
  • Cervical cancer or high-grade abnormal cells was diagnosed in 19 women (8%).
  • The majority (67%) of women referred were reassured and discharged back to routine screening after one visit.

What this tells us

While cervical screening after menopause can be challenging for the patient and the sample taker or colposcopist, this study demonstrates that screening is still important in women post-menopause, and women aged over 50 should be encouraged to attend for regular cervical screening.