Wednesday, August 20, 2014

Routine Pelvic Examinations Not Recommended For Asymptomatic, Non-Pregnant, Adult Women: Health Benefit To Routine Screening Not Found

From Medscape Medical News, "Value of Screening Pelvic Exam for Women Debated" by Lara C. Pullen, PhD:
The American College of Physicians (ACP) has issued new clinical guidelines recommending against screening pelvic examination in asymptomatic, nonpregnant, adult women. The college describes the recommendation as strong, with moderate-quality evidence.
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ACP has reviewed the literature and determined that the screening pelvic examination does not benefit adult women. Although the recommendations advise against pelvic examinations, the recommendation for Papanicolaou smears remains.
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The authors reviewed the evidence and found that the harms associated with screening pelvic examination outweigh the benefits. The guidelines also explain that screening for chlamydia and gonorrhoea, sometimes done by pelvic examination, can be reliably performed using nucleic acid amplification tests on self-collected vaginal swabs or urine. “[N]ucleic acid amplification tests on self-collected vaginal swabs or urine have been shown to be highly specific and sensitive, and this technique is supported by several organizations,” the authors write.

In their recommendation, they add, "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).