Pap Smear Recommendations After Hysterectomy

Content provided by the Faculty of the Harvard Medical School

Pap Smear Recommendations After Hysterectomy

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Question:

Is it necessary to get a yearly pap smear after you have had a hysterectomy?

Answer:

Pap smears are needed after hysterectomy in a few specific situations, but not in all women.

Pap smears test for cervical cancer and precancerous cells. A sample of cells is collected from the cervix and studied in a lab for abnormalities. Cervical cancer rates have dropped dramatically because of the use of Pap smears.

If a woman has a total hysterectomy, Pap smears are no longer needed. (A total hysterectomy is the removal of the cervix and body of the uterus.) One exception is women who have had a hysterectomy to treat cervical or uterine cancer. In this case, Pap smears of the top of the vagina are used to monitor for the return of any cancer. If a woman had a hysterectomy to treat precancerous cells in the cervix, Pap smear screening usually continues until three in a row are normal.

Women who have a subtotal or supracervical hysterectomy need regular Pap smear screening. In this type of hysterectomy, the cervix is left in place and only the upper part of the uterus is removed. The cervix remains at risk for cancer and precancerous change, so screening remains very important.

Joan Bengtson, M.D., is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics, Gynecology & Reproduction at Brigham and Women's Hospital.

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Last updated:	July 20, 2009

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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