Is Cervical Cancer Possible After Hysterectomy in 2025? Risks and Screening Explained

Wondering if cervical cancer can still develop after a hysterectomy? This is a common concern for many women who have undergone the procedure. In the United States alone, over 600,000 hysterectomies are performed annually, primarily to address conditions such as endometriosis, uterine fibroids, or reproductive cancers.

This article breaks down how the type of hysterectomy you had influences your ongoing risk for cervical cancer and what screening steps you should take moving forward.

Understanding Hysterectomy

A hysterectomy is a surgical procedure that removes the uterus, or womb, the organ where a fetus develops during pregnancy. The extent of removal varies depending on the type of hysterectomy performed.

Types of Hysterectomy

• Partial (Supracervical) Hysterectomy: Removes the upper part of the uterus but leaves the cervix intact.
• Total Hysterectomy: Removes both the uterus and the cervix.
• Hysterectomy with Salpingo-Oophorectomy: Includes removal of one or both ovaries and fallopian tubes along with the uterus (partial or total).

Hysterectomies are performed for various medical reasons, including uterine fibroids, pelvic inflammatory disease, endometriosis, uterine or cervical cancers, and abnormal bleeding.

Can Cervical Cancer Develop After a Hysterectomy?

Cervical cancer originates in the cervix and is usually caused by persistent infection with human papillomavirus (HPV). The risk of developing cervical cancer after hysterectomy depends largely on whether the cervix was removed.

With a partial hysterectomy, since the cervix remains, the risk for cervical cancer still exists. Cancerous or precancerous cells can develop in the remaining cervical tissue.

For those who have undergone a total hysterectomy, which removes the cervix, the risk is significantly reduced because the cervix is no longer present. However, if the hysterectomy was performed due to cervical cancer or precancerous conditions, there remains a chance that cancer cells may have spread beyond the cervix before surgery, meaning a recurrence is possible.

Research indicates that around 18% of patients treated with radical hysterectomy for cervical cancer experienced a recurrence, underscoring the importance of ongoing monitoring.

Post-Hysterectomy Cervical Cancer Screening: Pap Smears and HPV Tests

A Pap smear detects abnormal or cancerous cells in the cervix, while an HPV test identifies the presence of high-risk HPV strains that can lead to cervical cancer. These tests are vital tools for early detection and prevention.

Key Facts about Pap Smears:

• Quick, painless, and noninvasive procedure performed during a routine doctor visit.
• Cells are collected from the cervix and examined for abnormalities.

Key Facts about HPV Testing:

• Can be done alone or alongside a Pap smear (co-testing).
• Detects HPV infection before cell changes occur, enabling early intervention.

Screening Recommendations Based on Hysterectomy Type

Partial Hysterectomy

If your cervix remains intact, the American Cancer Society recommends continuing regular cervical cancer screening until age 65. After 65, if you have had no abnormal results in the past decade, screening may be discontinued.

Total Hysterectomy Due to Cervical Cancer or High-Grade Dysplasia

Experts advise ongoing cervical cancer screening for at least 20 years after surgery to monitor for potential recurrence.

Total Hysterectomy for Non-Cancerous Conditions

If your hysterectomy was not related to cervical cancer and included removal of the cervix, routine Pap smears and HPV tests are generally no longer necessary.

Ovarian Cancer Risk After Hysterectomy

Ovarian cancer affects the ovaries, which produce eggs and hormones. A hysterectomy removes the uterus but typically leaves the ovaries intact unless an oophorectomy is also performed. Therefore, ovarian cancer risk remains if the ovaries are not removed.

Summary

Your risk of cervical cancer after hysterectomy depends on the surgery type and the reason it was performed. Partial hysterectomies retain cervical tissue and require ongoing screening, while total hysterectomies for benign reasons generally eliminate the need for further cervical cancer tests. If your hysterectomy was related to cervical cancer, continued vigilance through screening is essential. Always consult your healthcare provider to determine the best screening plan tailored to your medical history.

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