Thursday, October 23, 2014
FAIRFIELD-SUISUN, CALIFORNIA
99 CENTS

Guideline: Most healthy women can skip pelvic exam

By
July 01, 2014 |

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.

The American College of Physicians, specialists in internal medicine, took a broader look.

Pelvic exams are appropriate for women with symptoms such as vaginal discharge, abnormal bleeding, pain, urinary problems or sexual dysfunction, the ACP said. And women should get their Pap smears on schedule — but a Pap doesn’t require the extra step of a manual pelvic exam, it said.

For symptom-free women, years of medical studies show routine pelvic exams aren’t useful to screen for ovarian or other gynecologic cancers, they don’t reduce deaths, and there are other ways, such as urine tests, to detect such problems as sexually transmitted infections, the doctors’ group reported in the journal Annals of Internal Medicine.

Moreover, pelvic exams can cause harm — from unnecessary and expensive extra testing when the exam sparks a false alarm, to the anxiety, embarrassment and discomfort that many women report, especially survivors of sexual abuse, the guidelines said.

No one knows how many women postpone a doctor’s visit for fear of a pelvic exam, Humphrey said.

Dr. Ranit Mishori, a family physician and associate professor at Georgetown University School of Medicine, said the new guideline “gets rid of an unnecessary practice” that takes up valuable time that could be put to better use.

“Many women will be happy to hear that, and I think also, frankly, many physicians will be happy to hear it. Many of us have stopped doing them for a long time,” said Mishori, who wasn’t involved with the recommendations.

Despite its continued recommendation for annual pelvic exams, the American College of Obstetricians and Gynecologists said in 2012 that patients should decide together with their providers whether to have them.

Sometimes that exam lets the doctor spot, say, problems around the uterus that might lead to questions about incontinence that the supposedly asymptomatic patient was too embarrassed to bring up, said ACOG vice president Dr. Barbara Levy.

“Women have an expectation that they’re going to have an exam” if they choose a gynecologist, Levy said.

An editorial published alongside the guidelines Monday cautioned that pelvic exams also look for noncancerous uterine and ovarian growths, and the scientific review didn’t address whether that’s beneficial.

Still, editorial coauthors Drs. George Sawaya and Vanessa Jacoby of the University of California, San Francisco, said that whether the new guideline changes doctors’ practice or not, it could lead to better evaluation of what “has become more of a ritual than an evidence-based practice.”

“Clinicians who continue to offer the examination should at least be cognizant of the uncertainty of benefit and the potential to cause harm through a positive test result and the cascade of events that follow,” they wrote.

 

The Associated Press

The Associated Press

LEAVE A COMMENT

Discussion | No comments

The Daily Republic does not necessarily condone the comments here, nor does it review every post. Read our full policy

.

Solano News

Children run for the sake of running

By Susan Hiland | From Page: A1 | Gallery

 
Suisun City streets: Better than Vallejo, worse than Dixon

By Ian Thompson | From Page: A1 | Gallery

 
60th Air Mobility Wing gets outstanding unit award

By Ian Thompson | From Page: A3

Real McCoy ferry to shut down Thursday

By Ian Thompson | From Page: A3

 
Nairobi, oldest giraffe at Six Flags, dies

By Amy Maginnis-Honey | From Page: A3 | Gallery

Day of Remembrance focuses on domestic violence prevention

By Amy Maginnis-Honey | From Page: A3 | Gallery

 
 
Audubon group to offer wetlands walk, bird workshop

By Susan Winlow | From Page: A4

 
 
Trailer rolls, knocks down pole, damages roadway

By Susan Winlow | From Page: A4

 
Bridge to Life gets extension for temporary kitchen

By Ryan McCarthy | From Page: A5

Pumpkin bob set at Fairfield city pool

By Ryan McCarthy | From Page: A5

 
Fairfield police log: Oct. 21, 2014

By Susan Hiland | From Page: A12

Suisun City police log: Oct. 21, 2014

By Susan Hiland | From Page: A12

 
.

US / World

Canada’s PM says shooting rampage was terrorism

By The Associated Press | From Page: A1

 
Davis votes to return armored vehicle

By The Associated Press | From Page: A5

Study looks at lane splitting in California

By The Associated Press | From Page: A5

 
125 San Francisco inmates to get computer tablets

By The Associated Press | From Page: A5

California malpractice cap generates big spending

By The Associated Press | From Page: A5

 
Huge gold nugget going up for sale in California

By The Associated Press | From Page: A5

Healdsburg bans tobacco sales to anyone under 21

By The Associated Press | From Page: A5

 
AP-GfK Poll: Public wants tighter Ebola screening

By The Associated Press | From Page: A6

Key features of rigorous new US Ebola monitoring

By The Associated Press | From Page: A6

 
Goofy dinosaur blends Barney and Jar Jar Binks

By The Associated Press | From Page: A6

Social Security benefits get another tiny increase

By The Associated Press | From Page: A6

 
US to track everyone coming from Ebola nations

By The Associated Press | From Page: A6

Teens’ travel renews concerns about terror appeal

By The Associated Press | From Page: A6

 
Blackwater guards found guilty in Iraq shootings

By The Associated Press | From Page: A6

Methodist panel hears appeal over gay wedding

By The Associated Press | From Page: A6

 
Analysis: Fowle was North Korea’s easiest US case

By The Associated Press | From Page: A10

UK man faked coma for 2 years to avoid court

By The Associated Press | From Page: A10

 
Missile, fire from Egypt wounds 2 Israeli troops

By The Associated Press | From Page: A10

Mexico: Mayor linked to deadly attack on students

By The Associated Press | From Page: A10

 
Nigeria truce is shaky, no news of abducted girls

By The Associated Press | From Page: A10

Iraqi Kurdish lawmakers OK fighters for Syria

By The Associated Press | From Page: A10

 
Prisons agree to end race policy

By The Associated Press | From Page: A12

.

Opinion

 
Don’t make this mistake after voting

By Kelvin Wade | From Page: A11

Editorial Cartoons: Oct. 23, 2014

By Daily Republic Syndicated Content | From Page: A11

 
Living a Democrat PC nightmare

By Letter to the Editor | From Page: A11, 1 Comment

Real reason to vote yes on 46

By Letter to the Editor | From Page: A11

 
Keck did good job researching issue

By Letter to the Editor | From Page: A11

.

Living

Today in History: Oct. 23, 2014

By The Associated Press | From Page: A2

 
Community Calendar: Oct. 23, 2014

By Susan Hiland | From Page: A2

 
Horoscopes: Oct. 23, 2014

By Holiday Mathis | From Page: A9

My husband visits dating sites, stays out until 3 or 4 a.m.

By Kathy Mitchell and Marcy Sugar | From Page: A9

 
.

Entertainment

TVGrid

By Daily Republic Syndicated Content | From Page: B6

 
‘SNL’ adds black woman to cast from writers room

By The Associated Press | From Page: A7

NBC promoting Weir, Lipinski to top skating team

By The Associated Press | From Page: A7

 
Annie Lennox embraces jazzy ‘Nostalgia’

By The Associated Press | From Page: A7

Renee Zellweger: ‘People don’t know me in my 40s’

By The Associated Press | From Page: A7

 
Sax player behind ‘Baker Street’ solo dies at 60

By The Associated Press | From Page: A7

.

Sports

AP source: Goodell told to testify in Rice appeal

By The Associated Press | From Page: B1 | Gallery

 
Kings measuring success on ‘wins and losses’

By The Associated Press | From Page: B1

Giants’ bullpen melts down in 7-2 loss to Royals

By The Associated Press | From Page: B1

 
Warriors hoping Kerr is final piece for title run

By The Associated Press | From Page: B1 | Gallery

Local Report: Armijo XC teams finish MEL 10-0

By Daily Republic staff | From Page: B1

 
Carr confident despite Raiders’ winless start

By The Associated Press | From Page: B1 | Gallery

Phony World Series tickets, merchandise seized

By The Associated Press | From Page: B2

 
Request denied to remove judge on Peterson case

By The Associated Press | From Page: B2

Probe: UNC academic fraud was ‘shadow curriculum’

By The Associated Press | From Page: B2

 
World Series rating for opener drops to low

By The Associated Press | From Page: B2

Beaten Giants fan shows significant progress

By The Associated Press | From Page: B2

 
Polian, Wolf nominated for Pro Football Hall of Fame

By The Associated Press | From Page: B2

Slumping Bears hope to slow No. 6 Oregon, Mariota

By The Associated Press | From Page: B2

 
Stanford picked to win Pac-12 regular-season crown

By The Associated Press | From Page: B2

NBA owners fail to pass lottery reform

By The Associated Press | From Page: B2

 
Leafs-Senators game postponed after shootings

By The Associated Press | From Page: B2

Brad Keselowski not concerned with popularity

By The Associated Press | From Page: B3 | Gallery

 
SHR swaps crews for Danica Patrick and Kurt Busch

By The Associated Press | From Page: B3 | Gallery

From Mexico to the World Series, Petit Giants’ shines

By The Associated Press | From Page: B4 | Gallery

 
’85 World Series Royals relishing playoff run

By The Associated Press | From Page: B4 | Gallery

 
This date in sports history for Thursday, Oct. 23, 2014

By The Associated Press | From Page: B5

.

Business

FedEx, UPS make plans for a better holiday season

By The Associated Press | From Page: B6

 
The top 20 US cities for tech startup funding

By The Associated Press | From Page: B6

‘Silicon Beach’ brings tech boom to Los Angeles

By The Associated Press | From Page: B6

 
Government ups air bag warning to 7.8M vehicles

By The Associated Press | From Page: B7

Camel maker Reynolds snuffs out workplace smoking

By The Associated Press | From Page: B7

 
BofA to refund Apple Pay customers charged twice

By The Associated Press | From Page: B7

Google unveils app for managing Gmail inboxes

By The Associated Press | From Page: B7

 
.

Obituaries

Dr. Robert M. Takamoto

By Nancy Green | From Page: A4

 
Mark Dean Lindsay

By Nancy Green | From Page: A4

Keith Bowen

By Nancy Green | From Page: A4, 1 Comment

 
Blanche Stevens

By Nancy Green | From Page: A4

.

Comics

Beetle Bailey

By Daily Republic Syndicated Content | From Page: A8

 
Dilbert

By Daily Republic Syndicated Content | From Page: A8

Peanuts

By Daily Republic Syndicated Content | From Page: A8

 
Frank and Ernest

By Daily Republic Syndicated Content | From Page: A8

Rose is Rose

By Daily Republic Syndicated Content | From Page: A8

 
Baby Blues

By Daily Republic Syndicated Content | From Page: A8

Garfield

By Daily Republic Syndicated Content | From Page: A8

 
For Better or Worse

By Daily Republic Syndicated Content | From Page: A8

Blondie

By Daily Republic Syndicated Content | From Page: A8

 
Pickles

By Daily Republic Syndicated Content | From Page: A8

Get Fuzzy

By Daily Republic Syndicated Content | From Page: A8

 
Wizard of Id

By Daily Republic Syndicated Content | From Page: A8

B.C.

By Daily Republic Syndicated Content | From Page: A8

 
Sally Forth

By Daily Republic Syndicated Content | From Page: A8

Zits

By Daily Republic Syndicated Content | From Page: A8

 
Baldo

By Daily Republic Syndicated Content | From Page: A8

Cryptoquote

By Daily Republic Syndicated Content | From Page: A9

 
Bridge

By Daily Republic Syndicated Content | From Page: A9

Crossword

By Daily Republic Syndicated Content | From Page: A9

 
Sudoku

By Daily Republic Syndicated Content | From Page: A9

Word Sleuth

By Daily Republic Syndicated Content | From Page: A9