Harvard Women's Health Watch

By the way, doctor: Do I need a Pap test after hysterectomy?

Q. I had a hysterectomy in my 50s. Do I still need to have Pap tests?

A. It depends on why the hysterectomy was performed and whether your cervix was removed during the procedure. If you had an abdominal hysterectomy and the surgeon didn't remove your cervix, you'll need to continue having Pap tests on a schedule determined by your age and risk for cervical cancer. If your cervix was removed during hysterectomy for a benign condition, such as fibroids or endometriosis, you don't need further Pap tests. But if you had a hysterectomy because of cervical, ovarian, or endometrial cancer, your clinician will need to continue Pap tests to monitor for any changes in your vaginal tissues.

Screening with a Pap test can detect abnormal cervical cells at an early stage, before they become cancerous. The test is performed during a pelvic exam. A clinician inserts a speculum into the vagina to part the vaginal walls and uses a tiny spatula or brush to gather cells from the cervix and endocervical canal, where most cervical cancers arise (see illustration above). The cells are placed on a slide or into a solution and sent to a laboratory for analysis. If a woman's cervix has been removed during hysterectomy for cervical cancer, the clinician will examine the vaginal tissue and obtain cells from the hysterectomy suture site.

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