Cervical Cancer Screening After Partial (Supracervical) Hysterectomy
Women who have undergone a partial (supracervical) hysterectomy with retained cervix should continue routine cervical cancer screening following the same guidelines as women who have not had a hysterectomy. 1
Screening Recommendations for Partial Hysterectomy
Continue standard screening protocols as the cervix remains in place and retains the same cancer risk as before surgery 1:
Age-Based Screening Strategy
- Ages 21-29 years: Perform cytology (Pap test) alone every 3 years 1
- Ages 30-65 years: Co-testing (cytology plus HPV testing) every 5 years is preferred, or cytology alone every 3 years is acceptable 1
- After age 65 years: Discontinue screening only if there have been 3 consecutive negative cytology results or 2 consecutive negative cotests within the past 10 years, with the most recent test within the past 5 years, AND no history of high-grade squamous intraepithelial lesions (HSIL), adenocarcinoma in situ, or cancer 1
Critical Distinction: Total vs. Partial Hysterectomy
The type of hysterectomy fundamentally determines screening needs:
- Total hysterectomy (cervix removed): Screening should be discontinued if performed for benign indications without history of high-grade precancerous lesions or cervical cancer 1
- Partial/supracervical hysterectomy (cervix retained): Continue routine screening as outlined above 1
Special Circumstances Requiring Extended Surveillance
If the partial hysterectomy was performed due to cervical intraepithelial neoplasia (CIN) 2 or CIN 3, surveillance must continue for at least 25 years after treatment, even if this extends beyond age 65 years 1:
- Initial post-treatment testing at 6,18, and 30 months using HPV testing or cotesting 1
- After completing initial testing, continue long-term surveillance at 3-year intervals with HPV testing or cotesting, or annual testing if using cytology alone 1
- If hysterectomy occurs during the surveillance period, vaginal screening should continue 1
Co-Testing Protocol Details
When performing co-testing in women aged 30-65 years with retained cervix 1:
- Both tests negative: Return to routine screening in 5 years 1
- HPV positive for types 16 or 18: Colposcopy is recommended regardless of cytology results 1
- HPV positive (not types 16/18) with normal cytology: Return in 1 year for repeat testing 1
- Any abnormal cytology: Follow standard management guidelines for abnormal results 1
Common Pitfall to Avoid
Do not assume that "hysterectomy" automatically means screening can stop 1. The critical question is whether the cervix was removed. Many patients and providers incorrectly believe all hysterectomies eliminate the need for cervical cancer screening, but partial hysterectomies leave the cervix intact and at continued risk 1. Always verify the surgical details before discontinuing screening.