A 35-year-old woman underwent total abdominal hysterectomy for CIN 3 with uninvolved margins four years ago. What is the recommended method of ongoing surveillance?
- A Annual vaginal vault cytology, as vaginal intraepithelial neoplasia can recur at the vault ✓
- B No further testing, since hysterectomy cures CIN
- C Routine HPV vaccination every five years
- D Colposcopy of the upper abdomen every six months
Correct answer: A. Annual vaginal vault cytology, as vaginal intraepithelial neoplasia can recur at the vault
Explanation
When hysterectomy is performed for high-grade CIN, residual or recurrent VaIN can develop at the vaginal apex years later, so periodic vault cytology is advised; Indian practice commonly recommends annual vault smears for several years before extending intervals. Hysterectomy removes the cervix but not the vaginal epithelium exposed to the same HPV field. Vaccination is preventive, not surveillance, and cannot substitute for cytology here.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.