Healthy women don't need regular pelvic exams the American College of Physicians (ACP) said in a new set of guidelines recently published in the Annals of Internal Medicine.
An expert panel appointed by ACP examined scientific research published from 1946-2014 that studied the effectiveness of the pelvic exam. The data suggested that pelvic exams don't reduce mortality and can lead to false alarms in 1.5-3 percent of cases, reported Wall Street Journal (WSJ).
"We found that the exam is not particularly good at detecting important disease, such as early ovarian cancer, and it can fool a physician into thinking she has detected an abnormality that, once you notice, will require further investigation," Molly Cooke, a member of the committee that wrote the guidelines said to WSJ.
The new guidelines only apply to the pelvic exam. The panel urged women to continue getting checked for cervical cancer.
Also, the experts emphasized that pelvic exams remain a necessary part of the evaluation in any woman with symptoms that could be related to a problem with the vagina, cervix, uterus, Fallopian tubes or ovaries, wrote Harvard Health Publications.
"There's no question that the Pap smear (which screens for cervical cancer) saves lives," Dr. Ranit Mishori at Georgetown University School of Medicine who wasn't involved in the new recommendation told NPR.org. "That part of the exam is not under question."
It is the bimanual exam that is under scrutiny. After the Pap smear, the doctor puts two fingers up the vagina and the other hand on the outside of the stomach. The doctor then examines the ovaries and uterus with both hands.
For decades, doctors thought the bimanual exam could help detect ovarian cancer. But studies haven't proven that to be true.
The American College of Obstetricians and Gynecologists said in a statement that women should consult with their health care providers about whether to have a pelvic exam.
Although the procedure is "not evidence-based," the organization said, it continues to endorse the exams because they can bring to light issues such as sexual dysfunction and incontinence.
According to some experts, the ACP research review does leave questions open, stated HealthDay News. For one thing, none of the studies looked at the accuracy of pelvic exams in screening for noncancerous growths.
For this reason, some gynecologists plan to continue advising patients to include a pelvic exam as part of their annual checkup. Although pelvic exams can be uncomfortable, they are important.
This is because many women with noncancerous growths and/or abnormalities don't realize that they have symptoms, David Fishman, obstetrics, gynecology and reproductive science professor at the Icahn School of Medicine at Mount Sinai Hospital told WSJ. Fishman added that 80 percent of women who develop ovarian cancer don't have any risk factors.
Sources:
Chen, Angela. "Routine Pelvic Exam Isn't Helpful, Report Says." The Wall Street Journal. Dow Jones & Company, n.d. Web. 18 Sept. 2014.
http://online.wsj.com/articles/regular-pelvic-exam-isnt-helpful-report-says-1404163414
Doucleff, Michaeleen. "Skip The Stirrups: Doctors Rethink Yearly Pelvic Exams." NPR. NPR, n.d. Web. 18 Sept. 2014.
http://www.npr.org/blogs/health/2014/06/30/326703530/skip-the-stirrups-doctors-rethink-yearly-pelvic-exams
LeWine, M.D., Howard. "Expert panel says healthy women don't need yearly pelvic exam - Harvard Health Blog." Harvard Health Blog RSS. N.p., n.d. Web. 18 Sept. 2014.
http://www.health.harvard.edu/blog/expert-panel-says-healthy-women-dont-need-yearly-pelvic-exam-201407027250
Norton, Amy. "Most Women Don't Need Regular Pelvic Exams, New Guidelines State." Consumer HealthDay. N.p., n.d. Web. 18 Sept. 2014.
http://consumer.healthday.com/cancer-information-5/cervical-cancer-news-95/most-women-don-t-need-regular-pelvic-exams-new-guidelines-state-689305.html
Reviewed September 26, 2014
by Michele Blacksberg RN
Edited by Jody Smith