Although it can feel counter intuitive, when it comes to medical screenings, sometimes the evidence tells us what not to do. That was the case when considering the data surrounding routine mammograms. And now there is similar evidence about pelvic exams for women.
Earlier this month, the American College of Physicians recommended against routine pelvic screenings for women. Their recommendation is based on a systematic review published in the Annals of Internal Medicine.
For the review, researchers examined 52 studies that measure the benefits and harms of conducting routine pelvic exams to detect ovarian cancer in women with no symptoms and who did not have higher risk factors.
They found that pelvic exams have a positive predictive value of 4 percent for identifying ovarian cancer. This means that only 4 percent of time, a person with a “positive” pelvic exam actually has ovarian cancer. In addition, some data show that pelvic exams cause pain, discomfort and anxiety for women. Between 11 and 60 percent of women reported pain and discomfort during pelvic exams, and between 10 and 80 percent reported fear or anxiety about the exam.
As a result, the American College of Physicians developed new guidelines that say pelvic exams should be omitted from well-visits for asymptomatic women who are not pregnant. The College of Physicians continues to recommend screening for cervical cancer and sexually-transmitted disease, but notes these can be accomplished without a full pelvic exam.
The take-home message for women: The next time you visit your primary care physician or gynecologist, ask about the new guidelines. For the vast majority of women, the evidence says pelvic exams are not necessary.
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