Effectiveness of Vaginal Papanicolaou Smear Screening After Total Hysterectomy for Benign Disease

Observations from the CDC: An Assessment of Pap Smears and Hysterectomies among Women in the United States

“…Physicians are concerned that if the association between the yearly Pap smear and the office visit is lost, women will not come in for other important routine tests, such as breast cancer screening and lifestyle counseling. 1,20,21 Whether it is appropriate to misinform a woman about why she needs to come in for her annual visit raises important ethical questions, however. 1 The findings in this report are subject to several limitations.…”

“…1,20,21 Whether it is appropriate to misinform a woman about why she needs to come in for her annual visit raises important ethical questions, however. 1 The findings in this report are subject to several limitations. First, we use self-reported data.…”

“…Concern is growing, however, that Pap smear screening may be used inappropriately for women who have had a hysterectomy. [1][2][3][4] Unfortunately, guidelines about whether women who have had a hysterectomy need to be screened are inconsistent. One group, the United States Preventive Services Task Force, recommends that women who have had hysterectomies in which the cervix was removed should not be screened for cervical cancer with a Pap smear unless they have a history of cervical cancer or its precursors.…”

Organizing Preventive Health Care in Men

“…Tobacco use screening and counseling (9) Screening for vision impairment among men aged 65 years and over (9) Colorectal cancer screening for men aged 50 years and over (8) Blood pressure check to screen for hypertension (8) Influenza vaccination for men aged 65 years and over (8) Pneumococcal vaccination for men aged 65 years and over (7) Lipid profile for men between age 35 and 65 (7) Alcohol abuse screening and counseling (7) Implementing services…”

“…Even if the initial preventive service is implemented appropriately, in most the studies, fewer than 75% of patients receive adequate follow-up care [7]. From the findings of these and other studies, preventive care procedures can be classified as underused, although overuse (eg, providing Papanicolau smears to women who have had total hysterectomies for benign uterine conditions [8]) and misuse (eg, performing digital rectal examination to check for fecal occult blood in lieu of three take-home fecal occult blood test cards [9]) could occur.…”