What's the point of a pelvic exam?

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No woman looks forward to a pelvic exam. Still, it has long been considered an essential part of an annual examination. Now, opinion may be turning against it.

No longer a recommended part of the annual exam

A new study by the American College of Physicians (ACP) shows that for healthy women the standard pelvic exam is likely doing more harm than good, causing the esteemed group to now advise against its inclusion in standard examinations. “Routine pelvic examination has not been shown to benefit asymptomatic, average risk, non-pregnant women. It rarely detects important disease and does not reduce mortality and is associated with discomfort for many women, false positive and negative examinations, and extra cost,” explained Dr. Linda Humphrey, member of the ACP.

Pap smears are still included

The new guideline applies only to pelvic exams. Pap smear screening for cervical cancer should be restricted to visual inspection of the cervix and swabbing to test for cancer and human papillomavirus (HPV).

Even doctors aren’t clear on the purpose of the pelvic exam

In a 2012 survey many physician mistakenly believed the pelvic exam was to screen for ovarian cancer. Many performed the exam only because the women expected it. It’s not a reliable test for cancer at all, but it is called for when symptoms are present. Abnormal bleeding, pain urinary problems, sexual dysfunction or vaginal discharge call for a pelvic exam.

“With the current state of evidence,” the ACP report adds, “clinicians who continue to offer the examination should at least be cognizant about the uncertainty of its benefits and its potential to cause harm through false-positive testing and the cascade of events it prompts.”

Source: MedicalNewsToday, Annals of Internal Medicine


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