Updated approach to screening for cervical cancer in older women.

Elderly women are inadequately screened for carcinoma of the cervix. Patient, physician, and laboratory factors are responsible for this "performance gap." Patients may be unaware of the need for routine screening; physicians other than obstetricians and gynecologists may not view cervical cancer screening as appropriate; and laboratories are under scrutiny for their quality control problems. Data from a Maryland study demonstrates the barriers to screening for the elderly: they receive sporadic screening, and office-based providers rarely offer this service. A simple protocol for management is suggested to reduce the morbidity and mortality attributable to cervical cancer.