Routine pelvic examination for asymptomatic women: exploring the evidence

Stewart, Rebecca Anne, and Thistlethwaite, Jill (2006) Routine pelvic examination for asymptomatic women: exploring the evidence. Australian Family Physician, 35 (11). pp. 873-876.

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Abstract

BACKGROUND: A routine pelvic examination is often performed as part of a 'well woman' check, in combination with a Pap test, sexually transmitted infection screening, or before commencing the contraceptive pill or hormone therapy. This check is also done at the woman's request, on the understanding that it may screen for ovarian cancer and other pathology.

OBJECTIVE: This article reviews the evidence regarding the use of routine pelvic examination in asymptomatic women as a screening test, and if the examination is performed, what information should be imparted to the patient to obtain informed consent.

DISCUSSION: Review of the literature indicates that the use of routine pelvic examination as screening for ovarian malignancy (with or without serum CA-125 and ultrasound) cannot be justified due to the low prevalence of the disease and low sensitivity and specificity of the examination. Pelvic examinations may be performed at the time of routine Pap tests to aid in technical issues with the Pap test itself, but are not recommended for screening purposes. There is no evidence to support pelvic examination of asymptomatic women taking hormone therapy or attending for a sexual health check. The performance of pelvic examination at the woman's request must be preceded by thorough gynaecological, medical and family history and after obtaining informed consent from the patient.

Item ID: 4134
Item Type: Article (Research - C1)
ISSN: 0300-8495
Keywords: physical examination; screening; ovarian neoplasm; asymptomatic; informed consent
Additional Information:

Copyright to Australian Family Physician. Reproduced with permission. Permission to reproduce must be sought from the publisher, The Royal Australian College of General Practitioners: www.afp.org.au

Date Deposited: 28 Oct 2009 03:57
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1114 Paediatrics and Reproductive Medicine > 111402 Obstetrics and Gynaecology @ 34%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111717 Primary Health Care @ 33%
11 MEDICAL AND HEALTH SCIENCES > 1112 Oncology and Carcinogenesis > 111299 Oncology and Carcinogenesis not elsewhere classified @ 33%
SEO Codes: 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920507 Womens Health @ 34%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920114 Reproductive System and Disorders @ 33%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920412 Preventive Medicine @ 33%
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