Most women can skip Pap smears after hysterectomy

ANN ARBOR, Mich. Most women who have undergone hysterectomy for non-cancerous diseases can forgo annual Pap smear exams, according to new research by University of Michigan Health System physicians.

The study, published in the July issue of the Journal of Lower Genital Tract Disease, found that even in the best conditions, women add only three weeks to their lives by having regular screenings. The cost of these screenings per year of life saved can run up to $12 million for more aggressive screening plans. It's the first study to look at the value of Pap smear screenings for women who have had a hysterectomy.

"Everyone thinks more prevention is better. What we found is that just because you have a test available doesn't mean you should use it. Some tests are not really going to lead to any benefit," says lead study author Michael Fetters, M.D., M.P.H., M.A., assistant professor of Family Medicine at the U-M Medical School.

More than a third of American women will undergo hysterectomy by age 60, making it the second most common major surgical procedure performed in the United States, behind the Caesarian section. Women most often require the procedure for benign conditions such as abnormal bleeding or uterine fibroids. A hysterectomy removes a woman's uterus, which usually includes the cervix.

Pap smear screenings have proven effective at detecting cervical cancer and have become a standard part of a woman's annual health check-up. Traditionally, physicians have continued to perform the test in women who have had hysterectomies, even though they no longer have a cervix, believing it may help detect vaginal cancer or other abnormalities.

"Why are doctors doing Pap smears on women who don't have a cervix? It doesn't make sense. But it became the standard of care," Fetters says. "There's really no significant value to doing it as a screening test."

Study authors used medical modeling to analyze different approaches to scr

Contact: Nicole Fawcett
University of Michigan Health System

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