Are Pap tests still needed after removal of the uterus (hysterectomy)?
Answer From Tatnai Burnett, M.D.
Pap test, also called a Pap smear, is a routine screening test for early diagnosis of cervical cancer.
If you had a partial hysterectomy — when the uterus is removed but the lower end of the uterus (cervix) remains — your doctor will likely recommend continued Pap tests.
Similarly, if you had a partial hysterectomy or a total hysterectomy — when both the uterus and cervix are removed — for a cancerous or precancerous condition, regular Pap tests may still be recommended as an early detection tool to monitor for a new cancer or precancerous change. In addition, if your mother took the drug diethylstilbestrol (DES) while she was pregnant with you, regular Pap tests are recommended, since DES exposure increases the risk of developing cervical cancer.
You can stop having Pap tests, however, if you had a total hysterectomy for a noncancerous condition.
Your age matters, too.
Doctors generally agree that women can stop routine Pap test screening after age 65 — whether you've had a hysterectomy or not — if you have a history of regular screenings with normal results and if you're not at high risk of cervical cancer.
If you're unsure whether you still need Pap tests, discuss with your doctor what's best for you.
Tatnai Burnett, M.D.
Oct. 22, 2020
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See more Expert Answers
- Feldman S, et al. Screening for cervical cancer. https://www.uptodate.com/contents/search. Accessed Sept. 17, 2018.
- Smith RA, et al. Cancer screening in the United States, 2018: A review of the current American Cancer Society guidelines and current issues in cancer screening. CA: A Cancer Journal for Clinicians. 2018;68:297.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Gynecology. ACOG Practice Bulletin No. 168. Cervical Cancer Screening and Prevention. Obstetrics & Gynecology. 2016;128:e111.
- Screening for cervical cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018;320:674.
- AskMayoExpert. Cervical cancer screening (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.