Choosing Wisely:

Don’t perform pelvic exams on asymptomatic nonpregnant women, unless necessary for guideline-appropriate screening for cervical cancer.

Rationale and Comments: Screening pelvic examinations, except for the purpose of performing cervical cancer screening at recommended intervals, have not led to reduction in mortality or morbidity, and expose asymptomatic women to unnecessary invasive testing. Noninvasive options to screen for sexually transmitted infections are now available as alternatives to endocervical cultures. Screening pelvic examinations also add unnecessary costs to the health care system, included expenses from evaluations of false-positive findings. These pelvic exams can even lead to unnecessary surgery.
Sponsoring Organizations:
  • American Academy of Family Physicians
  • Sources:
  • American College of Physicians guidelines
  • Disciplines:
  • Gynecologic
  • Preventive Medicine
  • References: • AAFP Clinical Preventive Service Recommendation: The AAFP recommends against screening pelvic exams in asymptomatic women. (2017) http://www.aafp.org/patient-care/clinicalrecommendations/all/screening-pelvic-exam.html.
    • Annals of Internal Medicine: Screening Pelvic Examination in Adult Women: A Clinical Practice Guideline from the American College of Physicians (Endorsed by the AAFP) http://annals.org/aim/fullarticle/1884537/screening-pelvic-examination-adult-women-clinical-practice-guideline-from-american.

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