ACP Against Pelvic Screening in Women

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ACP Against Pelvic Screening in Women
ACP Against Pelvic Screening in Women

(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 in the issue of the Annals of Internal Medicine.

In a review article, Hanna E. Bloomfield, MD, MPH, from the Minneapolis Veterans Affairs Health Care System, and colleagues examined the diagnostic accuracy, benefit, and harms of pelvic examination in asymptomatic, average risk, nonpregnant adult women. Data were extracted from 52 English-language studies, including 32 with primary data.

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The researchers found that pelvic examinations had a positive predictive value of less than 4% for detecting ovarian cancer. The percentage of women reporting pelvic examination-related pain or discomfort varied from 11% to 60%, while 10% to 80% reported fear, embarrassment, or anxiety related to pelvic examinations.

Amir Qaseem, MD, PhD, from the ACP in Philadelphia, and colleagues developed guidelines on the utility of screening pelvic examinations in adult women. The target patient population was asymptomatic, nonpregnant adult women. Based on a review of the evidence, the ACP recommended against screening pelvic examination in this population (strong recommendation, moderate-quality evidence).

"The current evidence shows that harms outweigh any demonstrated benefits associated with the screening pelvic examination," Qaseem and colleagues wrote.

Authors of an accompanying editorial noted that, even if the recommendations do not change clinical practice, clinicians performing the examination should be aware that its benefits are uncertain and that potential harm could occur.

References

  1. Bloomfield HE, Olson A, Greer N, et al. Screening Pelvic Examinations in Asymptomatic, Average-Risk Adult Women: An Evidence Report for a Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2014;161(1):46-53.
  2. Qaseem A, Humphrey LL, Harris R, et al. Screening Pelvic Examination in Adult Women: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2014;161(1):67-72.
  3. Sawaya GF, Jacoby V. Screening Pelvic Examinations: Right, Wrong, or Rite? Ann Intern Med. 2014;161(1):78-79.

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