Clinical Preventive Service Recommendation
Screening Pelvic Exam
Grade: D recommendation
The AAFP recommends against screening pelvic exams in asymptomatic women. (2017)
Note: The AAFP’s recommendation differs from the U.S. Preventive Services Task Force (USPSTF). The USPSTF determined there was insufficient evidence to assess the benefits and harms of performing screening pelvic examination in asymptomatic women for the early detection and treatment of certain gynecologic conditions. The USPSTF’s review did not include screening for ovarian cancer, cervical cancer, gonorrhea, or chlamydia, as these are already covered by other USPSTF recommendations. Yet malignancy and pelvic inflammatory disease are the leading gynecologic causes of morbidity and mortality in women. Screening for other conditions that have limited effect on morbidity or mortality are unlikely to provide substantial benefit. There is evidence of harms for performing screening pelvic exams in asymptomatic women due to the increased risk of invasive testing and unnecessary treatment. Given the low likelihood of benefit and the increased risk of harm, the AAFP recommends against screening pelvic exams.
These recommendations are provided only as assistance for physicians making clinical decisions regarding the care of their patients. As such, they cannot substitute for the individual judgment brought to each clinical situation by the patient's family physician. As with all clinical reference resources, they reflect the best understanding of the science of medicine at the time of publication, but they should be used with the clear understanding that continued research may result in new knowledge and recommendations. These recommendations are only one element in the complex process of improving the health of America. To be effective, the recommendations must be implemented.