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    Timothy J. Moynihan, M.D.

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Question

Ovarian cancer: Still possible after hysterectomy?

Is ovarian cancer still possible after a hysterectomy? If so, should I continue to have regular Pap tests?

Answer

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from Timothy J. Moynihan, M.D.

Yes, you still have a risk of ovarian cancer or a type of cancer that acts just like it (primary peritoneal cancer) if you've had a hysterectomy.

Your risk depends on the type of hysterectomy you had:

  • Partial hysterectomy or total hysterectomy. A partial hysterectomy removes your uterus, and a total hysterectomy removes your uterus and your cervix. Both procedures leave your ovaries and fallopian tubes intact, so you can still develop ovarian cancer.
  • Total hysterectomy with salpingo-oophorectomy. This procedure removes your cervix and uterus as well as both ovaries and fallopian tubes. This makes ovarian cancer less likely to occur, but it does not remove all risk. You still have a small risk of what's called primary peritoneal cancer, which acts just like ovarian cancer and is treated similarly. Peritoneal cancer may result from ovarian cells that migrated to the peritoneal area during each menstrual cycle before your ovaries were removed. These cells can become cancerous later on. Alternatively, since the peritoneum and ovaries arise from the same tissues during embryonic development, it's possible that cancer could arise from the cells of the peritoneum.

A Pap test is a screening test for cervical cancer, but it can't detect ovarian cancer. Currently, there are no effective screening tests for ovarian cancer. If you've had your cervix removed as part of a total hysterectomy, you usually don't need an annual Pap test. But if your hysterectomy was done because of cancer of the cervix or abnormal cells were previously found on the surface of your cervix (dysplasia), your doctor may recommend continued Pap tests.

You may still need regular pelvic exams after hysterectomy. Ask your doctor how often you should have a pelvic exam.

Next question
CA 125 test: A screening test for ovarian cancer?
References
  1. Hysterectomy. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp008.cfm. Accessed April 11, 2011.
  2. Pap test. WomensHealth.gov. http://womenshealth.gov/faq/pap-test.cfm. Accessed April 11, 2011.
  3. Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. April 11, 2011.
  4. Gallenberg MM (expert opinion). Mayo Clinic, Rochester, Minn. April 14, 2011.
AN01018 April 23, 2011

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