Doctors should stop performing routine pelvic exams, a key component of regular physicals for women, an influential medical group said Monday.
There is no evidence that such pelvic exams are useful and plenty to suggest the procedure provokes fear, anxiety and pain in many women, the American College of Physicians said in a new practice guideline for doctors.
The college's guideline was published in the Annals of Internal Medicine and was accompanied by an article reviewing the scientific evidence. The recommendation applies only to routine checkups for healthy women, not to women who visit the doctor's office with medical complaints or who are pregnant.
"The pelvic exam has become a yearly ritual, but I think it's something women don't necessarily look forward to," said Dr. Sandra Adamson Fryhofer, an internist in Atlanta who is a former president of the college. "A lot of women dread it."
The new recommendation contradicts guidelines from the American College of Obstetricians and Gynecologists, which immediately reiterated its support for yearly pelvic exams.
The American College of Physicians reviewed studies of the procedure and concluded that pelvic exams are not accurate diagnostic screening tests for ovarian cancer. A dozen studies have suggested that many women experience pain or discomfort during the exams, and they may be particularly traumatic for women who have been sexually assaulted.
The reviewers said that they could not even locate studies that had assessed whether routine pelvic exams of asymptomatic women could reduce death or disease from ovarian and other cancers, or benefit women with common benign conditions such as pelvic inflammatory disease, fibroids or warts.