Pap Smears after Hysterectomy:

Small benefit for many women, high cost to the health care system

Michael Fetters Photo: Gregory Fox

"Most women with hysterectomies don't need annual Pap smears," says Michael Fetters, M.D., an assistant professor of family medicine in the U-M Medical School. "Just because you have a test available, doesn't mean you should always use it."

Fetters directed the first cost-benefit analysis of Pap smear screening exams for cervical or vaginal cancer in women who had hysterectomies for benign disease. The study found that routine Pap screenings add no more than three weeks to these women's lives at a cost to the health care system of up to $12 million.

U-M researchers still recommend regular Pap smears for women whose hysterectomy was linked to cervical cancer or those with special risk factors associated with lower genital tract cancers. And even though a Pap smear may not be necessary, an annual visit to the doctor still is.

The study was funded by Blue Cross Blue Shield of Michigan Foundation, the American Academy of Family Physicians Foundation and the Robert Wood Johnson Foundation Generalist Faculty Scholars Program. U-M research collaborators included Richard W. Lieberman, M.D., clinical assistant professor of pathology and of obstetrics and gynecology; and Paul H. Abrahamse, research associate.

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Read an expanded version of this story:
www.med.umich.edu/opm/newspage/2003/skippap.htm

For more information on Pap smears:
www.med.umich.edu/1libr/aha/aha_papsmear_crs.htm