The Case For And Against Routine Annual Pelvic Exams Is Still Unclear : Shots - Health News There's not enough good evidence to make the call as to whether an annual pelvic exam is a good screening tool, the U.S. Preventive Services Task Force says.
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Are Routine Pelvic Exams A Must? Evidence Is Lacking, Task Force Says

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Are Routine Pelvic Exams A Must? Evidence Is Lacking, Task Force Says

Are Routine Pelvic Exams A Must? Evidence Is Lacking, Task Force Says

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ROBERT SIEGEL, HOST:

Every year, tens of millions of women get pelvic exams. A new report is questioning the need for such annual tests in healthy women who have no symptoms of disease. It's from a panel of experts from the U.S. Preventive Services Task Force, the same body that makes recommendations on Pap smears, which remain unchanged. NPR's Patti Neighmond explains.

PATTI NEIGHMOND, BYLINE: For most women over 21, the yearly pelvic exam is routine. Doctors examine internal and external reproductive organs to make sure there are no abnormalities. Dr. Kirsten Bibbins-Domingo chaired the task force.

KIRSTEN BIBBINS-DOMINGO: Probably the reason that physicians say most often that they think a pelvic exam may be important is for detection of ovarian cancer.

NEIGHMOND: But no studies have shown that to be true, and that's exactly the kind of evidence the task force was looking for. They wanted to know if there was any scientific data proving that the yearly pelvic exam helped detect disease.

BIBBINS-DOMINGO: We basically concluded that we didn't have enough evidence to recommend for or against the pelvic exam.

NEIGHMOND: Which is why the task force calls for more research to help figure out potential benefits and harms. In the meantime, Bibbins-Domingo says women should consult with their doctor about whether a pelvic exam is warranted.

BIBBINS-DOMINGO: If a woman has concern about anything going on with her body, she should absolutely schedule a visit with her doctor, and doctors should do the appropriate exams to understand symptoms that patients have.

NEIGHMOND: Symptoms such as unexpected bleeding or pain. In an editorial published along with the new policy, OB-GYN George Sawaya with the University of California, San Francisco, says while there may be no proven benefit to the yearly exam, there is a downside - false alarms.

GEORGE SAWAYA: There is certainly a possibility that we're going to find an abnormality that's going to lead to more tests.

NEIGHMOND: Which is the case for as many as 8 percent of all women who have a pelvic exam, and further testing can raise more suspicions. And for these women, up to one-third of patients end up having surgery.

SAWAYA: And most of these were for conditions that were not cancerous, so we could think about those as being false positives and unnecessary surgeries.

NEIGHMOND: Along with all the anxiety and worry about a potential cancer diagnosis. Sawaya says the timing was good to take a closer, more evidence-based look at the value of the pelvic exam.

SAWAYA: We live in an era where it's really important for us to make sure we have really excellent evidence when it comes to prevention because we don't want to harm well people in the present in our pursuit of trying to make them weller (ph) in the future.

NEIGHMOND: The American College of Obstetricians and Gynecologists still recommend annual pelvic exams for women 21 and older but in light of the task force findings plan to evaluate whether it needs to update its guidance. It's important to note the recommendation is not about the Pap smear which is often done along with the pelvic exam. The Pap smear is a proven and highly effective screening test for cervical cancer. The task force recommends women ages 21 to 65 have a Pap smear every three to five years. Patti Neighmond, NPR News.

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