From the Guidelines
No, Human Papillomavirus (HPV) cannot cause cancer after a hysterectomy with removal of the cervix, as the cervix, which is the primary site of HPV-related cancer, has been removed.
HPV and Cancer Risk
- The risk of HPV-related cancer is significantly reduced after a hysterectomy with removal of the cervix, as the cervix is the primary site of HPV-related cancer.
- According to the American College of Physicians, clinicians should not screen average-risk women of any age for cervical cancer if they have had a hysterectomy with removal of the cervix 1.
- The American Cancer Society also recommends that women who have undergone hysterectomy and have no history of CIN2+ should not be screened for vaginal cancer using any modality 1.
Screening Guidelines
- The guidelines for cervical cancer screening emphasize that screening can be discontinued after total hysterectomy for benign disease, if the cervix was completely removed 1.
- However, women who have had a hysterectomy with removal of the cervix should have screening for vaginal cancer if they have a history of CIN II or III lesions or cancer, or if a negative history cannot be documented 1.
HPV Infection and Cancer Risk
- While new HPV infections can occur after a hysterectomy, the risk of these infections progressing to cancer is low, especially in older women 1.
- Most new carcinogenic HPV infections in women over 65 years old should clear spontaneously, and only a small percentage is likely to persist 1.
From the Research
Human Papillomavirus (HPV) and Cancer Risk After Hysterectomy
- HPV is a common cause of various types of cancers, including cervical, oropharyngeal, and vaginal cancers 2, 3
- Studies have shown that HPV can still be present in the vaginal tissue after hysterectomy, particularly in women with a history of cervical intraepithelial neoplasia (CIN) or HPV infection 4, 5
- The risk of vaginal cancer after hysterectomy is lower than the risk of cervical cancer, but it is still a concern, especially in women with a history of HPV infection or CIN 4, 5
- Regular assessment of HPV infection during postoperative follow-up is recommended, especially in women with a history of CIN or HPV infection 5
- HPV vaccination and screening are important measures for preventing and detecting HPV-related cancers, including vaginal cancer after hysterectomy 2, 3, 6
HPV Infection and Vaginal Cancer Risk
- HPV infection can cause vaginal cancer after complete hysterectomy, especially in cases complicated by CIN 5
- The prevalence of oncogenic HPV types is higher in cervical tissue than in vaginal tissue, which may explain the lower incidence of vaginal cancer compared to cervical cancer 4
- However, HPV infection can still cause vaginal cancer, and regular assessment of HPV infection is necessary during postoperative follow-up 5
Prevention and Screening
- HPV vaccination is an effective measure for preventing HPV-related cancers, including cervical, oropharyngeal, and vaginal cancers 2, 3, 6
- Regular screening for HPV infection and cervical cancer is important for early detection and prevention of these diseases 2, 6
- Nurses play an important role in educating patients about HPV and preventive measures, as well as in screening and treatment 6