US health authorities are spending too much time and money scheduling Pap smears for women who have had a hysterectomy.

Investigators at the Centers for Disease Control (CDC) in Atlanta report that 21 per cent of US women have undergone hysterectomy and, over a period of 3 years, 78 per cent of them had a Pap smear, compared with 82 per cent of women with intact uteri. This translates to more than 10 million women who have received an unnecessary Pap smear at a cost of more than 375 million dollars.

Continued screening is only justified for those who have had supracervical hysterectomies (the cervix is left intact) and those originally diagnosed with cervical neoplasia (either benign or malignant tumours), say the researchers. On that basis, only 7-15 per cent of the women with hysterectomy require regular screening.

In spite of these findings, professional organisations such as the American College of Obstetrics and Gynecology and American Cancer Society, continue to recommend that all women should have regular Pap screening (Obstet Gynecol, 2001; 98: 269-78).