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Cervical Cancer Health Center

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Pap Tests Often Given When Not Needed

WebMD Health News
Reviewed by Laura J. Martin, MD

Dec. 3, 2012 -- Against clinical guidelines, many women are still getting Pap smears (a test that’s meant to find cancer of the cervix) even after they've had a total hysterectomy, which removes the uterus and cervix, according to a new government report.

The cervix is the “neck-like” lower part of the uterus. A Pap test uses cells scraped from the cervix to check for early changes that may indicate cervical cancer or precancer. The new report, from the CDC, looked at trends in Pap testing in U.S. women from 2000 to 2010.

In telephone surveys of thousands of women, about 60% of those over age 30 who said they’d had a hysterectomy also reported having a recent Pap smear in 2010.

Even though that number was down about 15 percentage points since 2000, researchers said it was still too high.

“Some of these women would need continued screening, for various reasons, but that’s a small percentage,” says researcher Meg Watson, MPH, an epidemiologist with the CDC’s Division of Cancer Prevention and Control. “We wouldn’t think it would be 60%.”

A hysterectomy is an operation that removes all or part of the uterus. The most common kind of hysterectomy is a total hysterectomy, or an operation that removes both uterus and cervix.

Even after the cervix has been removed, doctors can scrape cells from an area called the vaginal cuff. And in the past, Watson says, many doctors continued to perform the test even after a total hysterectomy to check for signs of vaginal cancers.

“But vaginal cancer rates are quite low,” Watson says, and subsequent studies have shown that using Pap smears to find vaginal cancers isn’t an effective strategy.

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