Do I need a pap smear after hysterectomy?

The American College of Obstetricians and Gynecologists recently released new guidelines describing how often women should receive a Pap test (we used to call it a Pap smear). These guidelines can be confusing because they vary depending upon age, HPV status and hysterectomy status. So how do you know if you should have a Pap test after hysterectomy?

What is a Pap Test?

Over the past 30 or so years, the rates of death from cervical cancer in women has gone down by half. This is mostly due to regular screening with the Pap test. This test is a simple and effective way of looking at the cells in your cervix (the lower part of your uterus) to see if they are abnormal. Abnormal cervical cells can develop into cancer if they are caused by HPV (human papillomavirus).

Cervical Cancer Screening

Cervical cancer still affects over 12,000 women in the U.S. each year. Of those women affected by cervical cancer, over 4,000 will die every year. Cervical cancer is an especially dangerous cancer for women because most women don’t show symptoms until the disease is in its late stages.

Like all cancers, cervical cancer has certain risk factors. As mentioned earlier, previous diagnosis of HPV is a risk factor. In the United States, women in certain ethnic groups including Hispanic, African-American, Asian and Pacific Islander are more likely to suffer from cervical cancer.

Cervical Cancer and Hysterectomy

If you’ve had a hysterectomy, you may no longer be at risk for cervical cancer, meaning you may no longer need Pap tests. However, the reason for your hysterectomy and the type of hysterectomy you had will determine if you need to continue Pap tests for cervical screening. The recommendations for Pap tests after hysterectomy are listed below, but please talk to your doctor if you have questions about whether or not you should be screened.

Pap Test Not Needed:

• You had a total hysterectomy that removed both your uterus and cervix.
• You had a hysterectomy for gynecological problems like fibroids, endometriosis, abnormal bleeding, postpartum hemorrhage or other reasons not related to reproductive cancers.

Pap Test Needed:

• You had a partial hysterectomy that removed only your uterus (not your cervix).
• You had a total hysterectomy that included your uterus and cervix because you had cervical cancer or abnormal cervical cells.

References:

ACOG. (2012, March). New cervical cancer screening guidelines announced. 

American Cancer Society. (2015, February 26). What are the key statistics about cervical cancer?

Content Sponsored by: MIRI Women – The Minimally Invasive Reproductive Surgery Institute (MIRI) brings together highly skilled, board-certified specialists who are focused on women’s health. Our team of professionals is trained in advanced gynecology, specifically hysterectomy surgery. Philosophically, our partner physicians take a “less is more” approach to health care, by first treating patients with the most conservative therapies. MIRI focuses on physical healing, while emphasizing that a patient’s emotional well-being is just as important.