Cervical Cancer Screening After Partial Hysterectomy
Yes, you absolutely need continued cervical cancer screening after a partial hysterectomy because your cervix remains intact, and you should follow the exact same screening guidelines as women who have not had any hysterectomy. 1
Understanding Partial (Subtotal/Supracervical) Hysterectomy
A partial or subtotal hysterectomy removes only the upper portion of the uterus while leaving the cervix in place. 1 This is fundamentally different from a total hysterectomy where the cervix is removed along with the uterus.
Screening Recommendations for Partial Hysterectomy
Women who have had a subtotal (supracervical) hysterectomy should continue regular cervical cancer screening exactly as if they had not undergone hysterectomy. 2, 1
Standard Screening Protocol
For women aged 21-29 years:
- Cervical cytology (Pap test) every 3 years 3
For women aged 30-65 years, choose one of these options:
- Cervical cytology alone every 3 years, OR
- High-risk HPV testing alone every 5 years, OR
- Co-testing (cytology plus HPV testing) every 5 years 3, 1
When to Stop Screening
Screening may be discontinued at age 65-70 years only if you meet ALL of these criteria:
- Three or more consecutive, technically satisfactory normal/negative cytology results 2
- No abnormal or positive cytology tests within the 10-year period prior to age 70 2
- No history of high-grade precancerous lesions (CIN 2/3) or cervical cancer 2
Critical Distinction: Total vs. Partial Hysterectomy
This is where confusion commonly occurs in clinical practice:
Total hysterectomy (cervix removed) for benign disease: Screening should be discontinued immediately, as it provides no benefit. 1, 3, 4 An estimated 10 million women in the United States are being screened unnecessarily after total hysterectomy for benign indications. 4
Partial hysterectomy (cervix remains): Continue all routine screening indefinitely until age criteria are met. 2, 1
Special High-Risk Situations Requiring Continued Screening
Even with a partial hysterectomy, certain conditions mandate indefinite screening regardless of age:
- History of CIN 2/3 or cervical cancer (continue for 20-25 years after treatment, even past age 65) 1, 5
- In utero diethylstilbestrol (DES) exposure 2, 1
- Immunocompromised status (HIV infection, organ transplant, chronic immunosuppressant therapy) 2, 1
For immunocompromised women, screening should occur twice during the first year after diagnosis, then annually thereafter. 2
Common Clinical Pitfalls to Avoid
Verify hysterectomy type through medical records: Many women and even some providers are unclear whether the cervix was removed. 1 Request operative reports or pathology records to confirm whether you had a total or partial hysterectomy before making screening decisions.
Do not apply total hysterectomy guidelines to partial hysterectomy: This is the most common error. Women with an intact cervix after partial hysterectomy remain at the same risk for cervical cancer as women who never had surgery. 2, 1
HPV vaccination does not eliminate the need for screening: Even vaccinated women who have had partial hysterectomy must continue screening according to standard guidelines. 2
The Bottom Line
Since your cervix remains in place after a partial hysterectomy, you retain the same cervical cancer risk as any woman with an intact cervix. 1 Continue routine screening with your healthcare provider using the age-appropriate protocol outlined above, and do not discontinue screening until you meet all the criteria for cessation at age 65-70 years.