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
- 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
||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
|Follow-up to be determined by the gynaecologist or
|Follow-up after radiotherapy
||No need for follow-up vault cytology unless specialist opinion
|For endometrial /ovarian carcinoma
||Suggest cancel recall unless specialist opinion indicates
- NHSCSP Publication No 1, Achievable Standards, Benchmark for
Reporting. Criteria for Evaluating Cervical Cytopathology, January
- NHSCSP Publication No 20, Colposcopy and Programme Management
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
- 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)