After a hysterectomy, you might wonder should you have a cervical screening test?
This depends on the reason why you had a hysterectomy and if the cervix was removed. If the hysterectomy was for benign reasons (e.g. fibroids, menorrhagia, prolapse) and there was no history of cervical intraepithelial neoplasia (CIN) or cervical cancer, no further cervical screening is needed.
The cervix has been removed, and the risk of developing cancer in the vaginal vault is extremely low.
If the hysterectomy was for high-grade CIN (CIN2/3) a vault smear (vault cytology) should be considered. There are no hard data on what exactly is the correct way to manage those that fall into this grouping. Despite the cervix being removed there is a risk of developing Vulvar or Vaginal cancer due to the challenge of not being able to get rid of the HPV in less aggressive ways.
Timing and frequency can vary, but a guideline considered is
- Typically: first vault smear 6 months after surgery
- Then annually until you have two consecutive negative results
- If both are negative → routine screening can stop
- If abnormal → further investigation (colposcopy of the vault)
If the cervix was not removed (subtotal/supracervical hysterectomy)
Continue routine cervical screening as per national guidelines, because the cervix is still present.