title: Low adherence to cervical cancer screening after subtotal hysterectomy.
abstract: BACKGROUND
  A reason for not recommending subtotal hysterectomy is the risk of cervical pathology. We aimed to evaluate cervical cancer screening and to describe cervical pathology after subtotal and total hysterectomy for benign indications.
  
  
  METHODS
  Data regarding adherence to screening and pathology results from the national Danish registry (Patobank) were obtained on women from a randomised clinical trial and an observational study of subtotal versus total abdominal hysterectomy from the time of surgery until 2014.
  
  
  RESULTS
  We included 501 women (259 subtotal hysterectomies and 242 total hysterectomies). The mean follow-up time was 14.1 years, and the mean age at follow-up was 62.1 years. After subtotal hysterectomy, 9.7% were not invited for screening. Adherence to screening was 61.4%; 8.5% were not screened. After total hysterectomy, 14.5% were not invited, 6.6% adhered to screening and 65.7% were not screened. We found a minimum of one abnormal test in 28 (10.8%) after subtotal hysterectomy and one after total hysterectomy. No cervical cancers were found.
  
  
  CONCLUSIONS
  Adherence to cervical cancer screening after subtotal hysterectomy in a Danish population is suboptimal and some patients have unnecessary tests performed after total hysterectomy. Clarification of the use of cervical/vaginal smears after hysterectomy is needed to identify women at risk of cervical dysplasia or cancer.
  
  
  BACKGROUND
  Research Foundation of Region Zealand, University of Southern Denmark, Nykøbing Falster Hospital, Rigs-hospitalet and Roskilde Hospital, Denmark.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT01880710.
authors.affiliation: lland@regionsjaelland.dk/lealairdandersen@gmail.com.
authors.forename: Lea Laird
authors.initials: LL
authors.lastname: Andersen
authors.forename: Lars Mikael Alling
authors.initials: LM
authors.lastname: Møller
authors.forename: Helga Margrethe
authors.initials: HM
authors.lastname: Gimbel
mesh_terms: D000328:Adult; D000368:Aged; D003718:Denmark; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods / Q000523:psychology*; D008403:Mass Screening / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D064887:Observational Studies as Topic; D010349:Patient Compliance; D016032:Randomized Controlled Trials as Topic; D012042:Registries; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D014591:Uterine Diseases / Q000150:complications / Q000523:psychology / Q000601:surgery