Study Questions Reasons for Routine Pelvic Exams
UCSF Study Finds Many Physicians Erroneously Believe Bimanual Exam Is Important For Ovarian Cancer Screening
By Elizabeth Fernandez | UCSF.edu | December 12, 2012
The pelvic exam, a standard part of a woman's gynecologic checkup, frequently is performed for reasons that are medically unjustified, according to the authors of a UCSF study that may lay the groundwork for future changes to medical practice.
The research shows that many physicians mistakenly believe the exam is important in screening for ovarian cancer. The study, which surveyed obstetricians and gynecologists around the country, also shows that doctors continue to perform the exam in part because women have come to expect it.
The article is currently published online in the American Journal of Obstetrics and Gynecology.
"The pelvic examination has been the foundation of the annual checkup for women for many decades, yet very little has been known about why clinicians perform it and if they believe it is useful," said senior author George Sawaya, MD, a UCSF professor of obstetrics, gynecology and reproductive sciences, and epidemiology and biostatistics. "We set out to better understand their practices and beliefs."
Well-woman annual medical checkups generally are recommended because they allow physicians to assess overall health and pinpoint potential problems early. Traditionally, these have included, among other assessments, a manual inspection of a woman's cervix and uterus and a Pap smear.
Under updated preventive care guidelines by the American Cancer Society, the American Congress of Obstetricians and Gynecologists (ACOG) and the U.S. Preventive Services Task Force, most women no longer need annual Pap smears, which screen for cervical cancer. Now, questions are being raised by the medical community about the necessity of the annual pelvic exam for women with no gynecologic problems such as pelvic pain or unscheduled bleeding.