What are recommendations for cervical cancer screening in women following hysterectomy?

Updated: Feb 12, 2019
  • Author: Cecelia H Boardman, MD; Chief Editor: Warner K Huh, MD  more...
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Answer

Women who have had a total hysterectomy may stop undergoing cervical cancer screening. Exceptions are as follows:

  • Women who had a hysterectomy without removal of the cervix

  • Women who have had a CIN grade 2 or 3 lesion treated in the past 20 years

  • Women who have had cervical carcinoma at any time

Women in whom co-testing shows a negative Pap smear but a positive HPV test should have 12-month follow-up cotesting. Women with atypical squamous cells of undetermined significance (ASCUS) on Pap smear but a negative HPV test can be rescreened with cotesting in 5 years or with cytology alone in 3 years. [3]

A study by Castle et al that included 990,013 women who had 1 or more HPV and cytology cotests in an 11-year period reported that five-year cervical intraepithelial neoplasia grade 3, adenocarcinoma in situ, and cervical cancer risks decreased after each successive negative co-test screening round (0.098%, 0.052%, and 0.035%). [59]


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