Health & Spirit

Debate surrounds the need for Pap test after hysterectomy

By Keith Roach, M.D. on

DEAR DR. ROACH: Could you please address the subject of the need for Pap tests after a hysterectomy? I had a total hysterectomy (uterus, cervix, fallopian tubes and ovaries) several years ago, in my late 50s, due to cancer, and I go for internal examinations regularly to both my general physician and the oncologist, but no further Pap tests have ever been done. I was told that once you have your cervix removed, there is no need for a Pap test. Several women I know continue to have Pap tests even after a hysterectomy. Why the discrepancy in the recommendation for this procedure? Thank you for your input. -- Anonymous

DEAR DR. ROACH: No woman, after a pelvic clean-out, should get a Pap. -- A.F.S., M.D., M.P.H.

ANSWER: The guidelines are clear that women who have had a total hysterectomy for cervical cancer should continue to have close follow-up, including a speculum and bimanual gynecologic exam as part of the complete physical exam. This is not the case for women who had a total hysterectomy for non-cancer reasons, such as fibroids; these women do not need Pap smears.

I agree with Dr. A.F.S. in that adding cervical cytology (the Pap smear) to the gynecologic exam may not add much benefit: In a recent study, only 6 percent of women with a recurrence of cervical cancer were diagnosed by the results of the Pap test. However, it seems to me, as a non-specialist, that it may still be worthwhile to obtain the Pap smear during the speculum exam, as even a 6 percent improvement means that some women will be diagnosed earlier than they otherwise would.

My strongly held opinion is that women with a history of cervical cancer continue to need screening for some period of time after treatment. This includes a complete gynecologic exam. Most experts feel that this should be done at least annually for at least five years (some groups recommend lifelong screening). I would leave the decision to obtain cervical cytology to the gynecologic oncologist treating the patient.

READERS: Recurring vaginal infections are often troubling to women. The booklet on that topic explains them and their treatment. Readers can order a copy by writing:

--Sponsored Video--

Dr. Roach

Book No. 1203

628 Virginia Dr.

Orlando, FL 32803


swipe to next page


blog comments powered by Disqus

Social Connections


Barney Google And Snuffy Smith Archie Hagar the Horrible Mike Du Jour Fowl Language Wizard of Id