Newspaper article

No Good Evidence That Routine Pelvic Exams Are Beneficial, Task Force Says

Newspaper article

No Good Evidence That Routine Pelvic Exams Are Beneficial, Task Force Says

Article excerpt

The pelvic exam -- a central (and often dreaded) element of a woman's annual visit with her doctor -- offers no proven advantages for healthy women, the U.S. Preventive Services Task Force (USPSTF) announced on Tuesday.

After conducting its first-ever review of the scientific evidence for this common procedure, the task force concluded "the current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic, nonpregnant adult women."

This finding adds to the mounting list of long-practiced medical procedures -- including screening mammograms and PSA tests for prostrate cancer -- that evidence-based reviews are discovering have questionable benefits.

The USPSTF's recommendation does not apply to screening exams for cervical cancer (Pap tests) and sexually transmitted diseases. Those screenings are "highly" recommended by the task force, but can be done with swabs and other testing methods that don't require a pelvic exam.

"There is not enough evidence to make a determination on screening pelvic exam in asymptomatic women for conditions other than cervical cancer screening, gonorrhea and chlamydia," said task force member Dr. Maureen Phipps in a released statement.

"Women with gynecologic symptoms or concerns should discuss them with their clinicians," she added.

'Inadequate evidence'

Doctors use pelvic exams to find several gynecologic conditions, such as endometriosis, uterine fibroids, pelvic inflammatory disease, cervical polyps and ovarian cysts. But the USPSTF found "inadequate evidence" to support the claim that finding and treating these conditions before they produce symptoms either saves lives or improves women's quality of life.

The task force also found "inadequate evidence" that routine pelvic exams cause harm, although they note that a few studies have reported that the exams' false-positive rates (the percentage of exams that suggest a woman has a medical problem when she doesn't) might be as high as 46 percent.

The false-positive rates in studies involving ovarian cancer, for example, range from 1.2 percent to 8.6 percent, but the likelihood that the woman actually has the disease is 0 percent to 3.6 percent.

Yet, studies also show that 5 percent to 36 percent of women whose pelvic exam suggested ovarian cancer go on to have surgery. …

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