Ovarian cancer: Still possible after hysterectomy?

Is ovarian cancer still possible after a hysterectomy? If this is true, should I continue to have regular Pap smears?

- Mary / Illinois

Mayo Clinic oncologist Timothy Moynihan, M.D., and colleagues answer select questions from readers.

Answer

A simple hysterectomy removes your cervix and uterus but leaves your ovaries and fallopian tubes intact. So you can still develop ovarian cancer.

Another type of hysterectomy called a total hysterectomy with salpingo-oophorectomy removes your cervix and uterus as well as both ovaries and fallopian tubes. Removing the ovaries dramatically reduces your risk — by more than 95 percent — of ovarian cancer. But you still have a small risk of primary peritoneal cancer, which acts just like ovarian cancer and is treated similarly. It's not clear why the risk of peritoneal cancer remains. But the cells on the inner lining of the abdomen (peritoneal) are very similar to the cells lining the surface of the ovaries.

There is no standardized screening test for ovarian or peritoneal cancer. A Pap smear is a screening test for cervical cancer. So, if you've had your cervix removed as part of the hysterectomy, you usually don't need an annual Pap smear. But you still need regular pelvic exams. Doctors also recommend continued Pap smears for women who have had cervical, vaginal or vulvar cancer before a hysterectomy.