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Saturday, October 13, 2012

I underwent hysterectomy, should I still get a pap smear?

It depends.   In general if you have your uterus and cervix removed for benign causes and you never had abnormal pap smear in the past, you don't have to get pap smear anymore.   You may still need a regular pap smear if:
- you had partial hysterectomy where the uterus was removed but your cervix was left in
- you had hysterectomy due to cervical cancer or dysplasia (abnormal cell growth in the cervix)
- you had history of abnormal pap smear before your hysterectomy
- your doctor or practitioner recommends it

The recommendation for routine pap smear has changed as well.  The starting age used to be 18 years old or 3 years after becoming sexually active.   Now most health organizations recommend starting pap smear at age 21 years old.  They did this knowing that there will be younger girls develop cervical cancer since the screening age is moved up.   Their reasoning is pap smear is to reduce number of cancer but will never eliminate it.  In the same time, pap smear at early age may increase surgery done in young girls.

The frequency of screening pap smear has also been changed from every year to every 2-3 years (from age 21 to 30 years old), then every 3-5 years with cotesting (pap smear + high risk HPV testing).

If you are confused, you are not alone since the guidelines keep on changing that even many doctors have difficulty keeping up with the changes.   There should be new recommendations coming from ASCCP and probably NCCN on pap smear probably in spring 2013.  Stay tune...

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