Many women will be happy with the USPSTF – that learned body that reviews medical interventions and decides which are worthwhile.
They have come out with a draft recommendation that I know will please many of my patients. To stop doing yearly pelvic exams.There are 63 million pelvic exams performed per year at a cost of $2.6 billion. But the USPSTF says there’s not enough evidence to justify doing them every year in asymptomatic, non-pregnant women.
It isn’t inherently harmful (though most women I’ve spoken to would gladly forgo this particular treat) but there is insufficient evidence of benefit to justify doing them every year they say. And as with any test, it can lead to other, unnecessary, interventions.
A report in our local paper by the Washington Post notes the American College of Physicians agrees – quoting a review of 60 years worth of research that there’s no evidence that this catches cancer or other disease.
They also incidentally report on one “particularly telling study” about doctors motivation. That pelvic exams are sometimes done “to ensure adequate compensation.”
It would be wicked to imply this could be anything to do with the resistance the American College of Obstetrics and Gynecology is voicing to the USPSTF’s recommendations. The ACOG take is that pelvic exams build trust. And whether or not to have one annually should be an individual choice between patient and doctor.
This recommendation by the USPSTF should not be interpreted to mean that pap smears are no longer recommended – but the current recommendations are not for these to be done every year.
I guess we guys are liable to get nabbed for a prostate exam as equivalent in discomfort and indignity – but most men I know would be happy if someone recommended less of the old digital exam*. Inn the same way, I expect many women will be happy with the USPSTF.
* The “schoolboy howler” type joke about old doctors is that they think “digital medicine” is not something to do with computers, but doing a prostate exam.