The Norman Transcript

Nation/World

July 6, 2014

Guideline: Most healthy women can skip pelvic exam

WASHINGTON — No more dreaded pelvic exam? New guidelines say most healthy women can skip the yearly ritual.

Routine pelvic exams don’t benefit women who have no symptoms of disease and who aren’t pregnant, and they can cause harm, the American College of Physicians said Monday as it recommended that doctors quit using them as a screening tool.

It’s part of a growing movement to evaluate whether many longtime medical practices are done more out of habit than necessity, and the guideline is sure to be controversial.

Scientific evidence “just doesn’t support the benefit of having a pelvic exam every year,” said guideline coauthor Dr. Linda Humphrey of the Portland Veterans Affairs Medical Center and Oregon Health & Science University.

“There will be women who are relieved, and there are women who really want to go in and talk with their doctor about it and will choose to continue this,” she added.

The recommendations aren’t binding to doctors — or insurers.

Indeed, a different doctors’ group, the American College of Obstetricians and Gynecologists, still recommends yearly pelvic exams, even as it acknowledges a lack of evidence supporting, or refuting, them.

Pelvic exams have long been considered part of a “well-woman visit,” and some 62 million were performed in the United States in 2010, the latest available data.

Here’s what put the test under the microscope: Pap smears that check for cervical cancer used to be done yearly but now are recommended only every three to five years. So if women weren’t going through that test every year, did they still need the pelvic exam that traditionally accompanied it?

During a pelvic exam, a doctor feels for abnormalities in the ovaries, uterus and other pelvic organs. But two years ago, scientists at the Centers for Disease Control and Prevention reported that the internal exams weren’t a good screening tool for ovarian cancer and shouldn’t be required before a woman was prescribed birth control pills.

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