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To the Editor: Self-reporting of Papanicolaou (Pap) smears by patients, which was used in the study by Drs Sirovich and Welch,¹ may be subject to overreporting, as patients tend to associate Pap smears with any speculum examination. A better estimate may come from commercial laboratories that also tend to collect information on patient characteristics such as hysterectomy status. Insinga et al² reported lower Pap smear utilization using data from the Kaiser Permanente Northwest Health Plan compared with national surveys based on patient self report.

One reason for the tendency of physicians to perform Pap smears in patients who have undergone hysterectomy may be lack of knowledge of the indication for the hysterectomy. A Pap smear is still recommended after a hysterectomy for women with a history of cervical dysplasia or cancer, or of in utero exposure to diethylstylbesterol. The Pap smear may also serve as an important way of bringing . . . [Full Text of this Article]

Vani Dandolu, MD
dandolu@tuhs.temple.edu
Department of Obstetrics and Gynecology

Oz Harmanli, MD
Division of Urogynecology
Temple University Hospital
Philadelphia, Pa

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