New guidelines recommend against pelvic screening

Pelvic examinations had a predictive value of less than 4% for detecting ovarian cancer.

New guidelines recommend against pelvic screening
New guidelines recommend against pelvic screening

HealthDay News -- The American College of Physicians (ACP) recommends against pelvic screening for asymptomatic adult women, according to a systematic review and clinical guidelines published the Annals of Internal Medicine.

Pelvic examinations had a predictive value of less than 4% for detecting ovarian cancer, Hanna E. Bloomfield, MD, MPH, of the Minneapolis Veterans Affairs Health Care System, and colleagues reported after examining the diagnostic accuracy, benefits and harms of pelvic screening in asymptomatic, average risk, non-pregnant female patients.

Data were extracted from 52 English-language studies, including 32 with primary data. The percentage of women reporting pelvic examination-related pain or discomfort varied from 1% to 60%, while 10% to 80% reported fear, embarrassment, or anxiety related to pelvic examinations.

Based on a review of the evidence, Amir Qaseem, MD, PhD, of the ACP in Philadelphia, and colleagues developed guidelines on the utility of screening pelvic examinations in female patients. The target patient population was asymptomatic, non-pregnant adult women.

“With the available evidence, we conclude that screening pelvic examination exposes women to unnecessary and avoidable harms with no benefit (reduced mortality or morbidity rates),” wrote the guideline authors.

The researchers noted that the guideline is focused on screening asymptomatic female patients, and that full pelvic examination with biannual examination is indicated in some nonscreening clinical situations.

This guideline does not address female patients who are due for cervical cancer screening, the investigators explained.

“The recommended cervical cancer screening examination should be limited to visual inspection of the cervix and cervical swabs for cancer and human papillomavirus and should not entail a full pelvic examination,” stated the researchers.

References

  1. Bloomfield HA. Ann Intern Med. 2014; doi:10.7326/M13-2881
  2. Qaseem A. Ann Intern Med. 2014; doi:10.7326/M14-0701
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