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In some types of hysterectomy, the entire uterus is removed, including the cervix (the opening to the uterus). The Pap smear is primarily used to screen for cervical dysplasia (precancerous changes) and cancer of the cervix, so if you have had your cervix removed, you usually won't need to have regular Pap smears. In other types of hysterectomies, the cervix is left intact, and the portion of the uterus above the cervix is removed. In this case, the cervix is still present and Pap smears are still required.
In the past, Pap smears were still recommended for women who had hysterectomies, as a way to screen for potential cancers of the vaginal wall, but these recommendations have changed based upon newer research. However, if a hysterectomy was performed because of a cervical cancer, or if there is a history of human papillomavirus (the virus associated with cervical cancer) infection, Pap smears are generally still performed even after hysterectomy. The same holds true for women who have risk factors for lower genital tract (including vaginal) cancers, such as sexually transmitted diseases, multiple sexual partners, or a change in immune system functioning.
Regular pelvic examinations and health screenings are still recommended for all women, including those who have had a hysterectomy.
Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care
"Screening for cervical cancer"