Women who have undergone a hysterectomy do not need to be screened for cervical cancer, and yet a startling number of women are still receiving Pap smears, according to the Centers for Disease Control and Prevention (CDC).
Of the nearly 22 million women who have had hysterectomies, approximately 60 percent have recently had a Papanicolaou (Pap) test. Since the procedure involves removing the entire cervix in 94 percent of cases, these tests are unnecessary. Receiving Pap smears after a hysterectomy has been discouraged by all major organizations for the last decade, according to Medscape.
The CDC has said that, in women who have had the cervix removed, any benefits from cervical cancer screenings “might be outweighed by the net harm.” This includes receiving a false-positive, which might lead to the patient undergoing unnecessary, invasive, and not to mention expensive, procedures.
“The false-positive rate…is indeed a great potential harm to women and cost to the healthcare system,” said Dr. Diane Harper, professor of community and family medicine/obstetrics and gynecology at Dartmouth Medical School.
However, since the CDC report was based on self-reported information between 2000 and 2010, there is “ample evidence to show that women of all ages are not cognizant of what a Pap test is,” according to Harper. She said most women believe any type of pelvic examination, whether a speculum has been used or not, is a Pap test. In reality, a Pap test may be performed as part of a pelvic examination, but the two are not mutually exclusive.
The CDC report also found that women 22 to 30 years old were having annual Pap tests instead of every three years per updated guidelines.
As we previously reported, cervical cancer screening guidelines had been changed for the first time in nearly ten years in March 2012. Three years earlier, the American College of Obstetricians and Gynecologists began advocating for new guidelines that called for less frequent cervical cancer screenings, which would reduce the harm of false positives while maintaining a reduction in cancer deaths.