Your teen daughter likely doesn’t need a pelvic exam, research suggests. Here’s why
Hundreds of thousands of teenage girls are being subjected to unnecessary pelvic and cervical exams because doctors aren’t aware of guidelines on when to perform the exams, according to research released Monday by the University of California, San Francisco.
“Recent media reports have called attention to inappropriate gynecologic examinations in young women,” said the study’s senior author, Dr. George F. Sawaya, a professor of obstetrics, gynecology and reproductive sciences at UCSF and director of the UCSF Center for Healthcare Value. “Parents of adolescents and young women should be aware that cervical cancer screening is not recommended routinely in this age group.”
Pelvic exams are not necessary prior to getting most contraceptives, added Sawaya, whose research was published Monday in JAMA Internal Medicine. He added the exams are often are not needed, even when clinicians are screening for sexually transmissible infections.
The American College of Obstetricians and Gynecologists, the American Cancer Society and the U.S. Preventive Services Task Force do not recommend cervical cancer screenings or pelvic exams for anyone under age 21.
After reviewing population-based data from 2011 to 2017, Sawaya and other researchers found that, in a single year, there were 1.4 million pelvic examinations and 1.6 million Pap tests performed on U.S. females ages 15 to 20 who had no condition or symptoms meriting them.
If a young woman used a hormonal contraception other than an IUD, they were 75 percent more likely to be given a Pap test and 31 percent more likely to receive a pelvic examination, as compared with those who did not use those contraception methods.
Researchers estimated the cost of the unnecessary exams amount to roughly $123 million per year.
A pelvic exam is considered to be medically necessary if a patient is pregnant, using an intrauterine device or requires treatment for a sexually transmitted disease.
“This study suggests that healthcare providers and young women need to communicate clearly and often about the best time for these tests,” said first author Jin Qin, an epidemiologist with the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention. “We want to ensure that guidelines are followed, and lives are saved.”
Many types of cervical cancer can be prevented with the vaccine for the human papillomavirus if children get the shot before ages 11 or 12. Prevention levels decline if children are vaccinated at later ages, according to officials with the American Cancer Society.
More than 31,500 men and women are diagnosed with HPV-caused cancers annually in the United States, the cancer society noted, but the vaccine protects against 90 percent of the 100-plus varieties of cervical, vaginal, throat, penile, anal and vulvar cancer caused by HPV.
This story was originally published January 6, 2020 at 8:00 AM.
