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Doctor Group No Longer Recommends Pelvic Exams for Well Women

Check-ups cost U.S. health care system $2.6 billion annually

The American College of Physicians (ACP) has changed its clinical practice guideline for well-woman visits. The group now says that women should not receive pelvic examinations during these visits. The ACP’s revised recommendation does not apply to women who are pregnant or who have symptoms of pelvic disease.

In developing their new guideline, the authors conducted a systematic review of the published literature in the English language from 1946 through January 2014.

No studies were identified that addressed the diagnostic accuracy of pelvic examination for asymptomatic pelvic inflammatory disease, gynecologic cancer other than cervical or ovarian cancer, or benign conditions.

Further, the authors say that many false-positive findings are associated with pelvic examination, with attendant psychological and physical harms, as well as harms associated with the examination itself. Harms of pelvic examination include unnecessary laparoscopies or laparotomies, fear, anxiety, embarrassment, pain, and discomfort.

“The current evidence shows that harms outweigh any demonstrated benefits associated with the screening pelvic examination,” the authors conclude.

According to the new report, pelvic exams for healthy women are believed to cost the U.S. health care system $2.6 billion annually.

In addition to the ACP’s new guideline, the American Cancer Society has not recommended an annual pelvic exam for healthy woman for the past 10 years. Nevertheless, the American College of Obstetricians and Gynecologists (ACOG) released a statement saying that the group would continue to stand behind its current guidelines that an annual pelvic exam is recommended for all patients over the age of 21.

Sources: Annals of Internal Medicine; July 1, 2014; and Kaiser Health News; July 1, 2014.

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