Guideline: USPSTF makes no recommendation for pelvic exams to screen for gynecologic conditions in asymptomatic women
- Budenholzer, Brian MD
Guideline scope
This guideline focuses on pelvic examinations (≥ 1 of external genitalia inspection, internal speculum examination, bimanual palpation, and rectovaginal examination) for screening for gynecologic conditions other than cervical cancer, gonorrhea, or chlamydia in women ≥ 18 years of age who are asymptomatic and neither pregnant nor at increased risk for specific gynecologic conditions.
Guideline methods
The US Preventive Services Task Force (USPSTF) commissioned a systematic review, which searched MEDLINE, PubMed, and Cochrane Central Register of Controlled Trials (all to Jan 2016, with surveillance using article alerts and targeted journal searches to Aug 2016), ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, and reference lists for English-language, good- or fair-quality (USPSTF criteria) studies done in developed countries that assessed the effectiveness, harms, and diagnostic accuracy of screening pelvic examinations for benign or malignant gynecologic conditions. The review found 9 studies: 8 reported diagnostic accuracy of screening for ovarian cancer or infectious diseases, and 9 reported screening harms. Based on the results of the review, the USPSTF made a statement about screening pelvic examinations.
Results and recommendations
The main results of the review are in the Table; no studies assessing the effectiveness of screening pelvic examinations were found.
USPSTF statement: Insufficient evidence exists to assess the balance of benefits and harms of pelvic examinations to screen for gynecologic conditions in nonpregnant, asymptomatic women (grade I based on lack of evidence or poor quality or conflicting evidence). The statement does not apply to screening for cervical cancer using Papanicolaou (Pap) smear, gonorrhea, or chlamydia.
Conclusions
The USPSTF states that insufficient evidence exists to make recommendations regarding pelvic examinations for screening for gynecologic conditions in asymptomatic, nonpregnant women. The statement does not apply to screening for cervical cancer, gonorrhea, or chlamydia.