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Follow-up after total hysterectomy

Vault cytology to be taken in colposcopy - not primary care

Follow-up after total hysterectomy:

Where there is no CIN or invasive cervical cancer on histology
  • For women on routine recall: Suggest cancel recall.
  • For women not on routine recall: Take vault sample at 6 months, then suggest cancel recall if negative.
For fully excised CIN/CGIN Suggest cancel recall after 2 subsequent negative cytology tests at 6 months and 18 months after surgery.
For incomplete or uncertain excision of CIN 1 Follow-up vault cytology at 6 and 12 and 24 months.
Follow-up continues until age 65 or until 2 years after surgery (whichever is later)
For incomplete or uncertain excision of CIN 2, CIN 3 or CGIN Follow-up vault cytology at 6 and 12 months. Then annual follow-up for a total of 10 years.
Follow-up continues until age 65 or until 10 years after surgery (whichever is later)
For invasive cervical carcinoma
(no radiotherapy)
Follow-up to be determined by the gynaecologist or oncologist
Follow-up after radiotherapy No need for follow-up vault cytology unless specialist opinion indicates otherwise.
For endometrial /ovarian carcinoma Suggest cancel recall unless specialist opinion indicates otherwise.

 

References

  • NHSCSP Publication No 1, Achievable Standards, Benchmark for Reporting. Criteria for Evaluating Cervical Cytopathology, January 2013
  • NHSCSP Publication No 20, Colposcopy and Programme Management 2010


In July 2005, the North West Regional Quality Assurance Reference Centre issued additional guidance for follow-up cytology after radical hysterectomy and radiotherapy for the treatment of cervical cancer

  • Women who have undergone radical hysterectomy for cervical cancer: In general, cytological follow-up is not recommended in the assessment of these women but decisions regarding this small group of patients should be determined by the gynaecological oncologist who carries out the procedure
  • Women who have undergone radiotherapy for the treatment of cervical cancer: Cervical or vaginal vault cytology should not be performed on women who have undergone radiotherapy as part of their treatment

 

(Last updated August 4th 2015)