Dear Dr. Bone,
My gynecologist wants me to have a pap smear. I had a partial
hysterectomy 3 years ago and no longer have a cervix. Do I really need a Pap
smear to screen for cervical cancer if I don’t have a cervix?
A.M.
Dear A.M.,
What a smart patient you are! The pap does screen for
cervical cancer. If you don’t have a cervix, you probably do not need a pap
smear. If your hysterectomy was done for pre-cancer or cancer of the cervix,
then I would continue to screen you with pap smears. In my residency many years
ago, we were taught to do yearly paps on everyone without a cervix to find
vaginal cancer. I have never seen a case. We now know that the HPV virus is the
cause of cervix cancer and warts. If you are in a stable, monogamous sexual
relationship or are not sexually active, then I would no longer do a pap smear.
On the other hand, if you have a new partner or there is a question about your
spouse’s fidelity, then I would screen you with a pap and HPV every three years
(unless one or the other are abnormal). I refer you to the American College
~Dr. Bone.
