Screening Pelvic Examinations in Asymptomatic, Average-Risk Adult Women
Authors: Hanna E. Bloomfield, Andrew Olson, Timothy J. Wilt
Journal: Annals of Internal Medicine (2014)

Letters16 December 2014Screening Pelvic Examinations in Asymptomatic, Average-Risk Adult WomenHanna E. Bloomfield, MD, MPH, Andrew Olson, MD, and Timothy J. Wilt, MD, MPHHanna E. Bloomfield, MD, MPHFrom Minneapolis Veterans Affairs Health Care System and University of Minnesota, Minneapolis, Minnesota., Andrew Olson, MDFrom Minneapolis Veterans Affairs Health Care System and University of Minnesota, Minneapolis, Minnesota., and Timothy J. Wilt, MD, MPHFrom Minneapolis Veterans Affairs Health Care System and University of Minnesota, Minneapolis, Minnesota.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5034-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:First, our literature search included all gynecologic conditions, not just noncervical cancer and pelvic inflammatory disease.Second, we agree that lack of evidence does not mean lack of value, but it does mean that value has not been empirically shown. Value is defined as the magnitude of benefit relative to the cost. We found no evidence of benefit for pelvic examination (excluding that done for cervical cancer screening) in asymptomatic, average-risk women. Without demonstrable benefit, there cannot be value.Third, Drs. Jennings and Blake point out that pelvic examination sometimes reveals abnormalities. The issue, however, is not whether ...References1. Buys SS, Partridge E, Black A, Johnson CC, Lamerato L, Isaacs C, et al; PLCO Project Team. Effect of screening on ovarian cancer mortality: the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Randomized Controlled Trial. JAMA. 2011;305:2295-303. [PMID: 21642681] doi:10.1001/jama.2011.766 CrossrefMedlineGoogle Scholar2. Sawaya GF, Jacoby V. Screening pelvic examinations: right, wrong, or rite? [Editorial]. Ann Intern Med. 2014;161:78-9. [PMID: 24979453] doi:10.7326/M14-1205 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Minneapolis Veterans Affairs Health Care System and University of Minnesota, Minneapolis, Minnesota.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-2881. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening Pelvic Examinations in Asymptomatic, Average-Risk Adult Women: An Evidence Report for a Clinical Practice Guideline From the American College of Physicians Hanna E. Bloomfield , Andrew Olson , Nancy Greer , Amy Cantor , Roderick MacDonald , Indulis Rutks , and Timothy J. Wilt Screening Pelvic Examinations in Asymptomatic, Average-Risk Adult Women John C. Jennings and Jennifer Blake Screening Pelvic Examinations in Asymptomatic, Average-Risk Adult Women John C. Jennings and Jennifer Blake Metrics Cited ByDetection of early stage ovarian cancer in a large community cohort 16 December 2014Volume 161, Issue 12Page: 924-925KeywordsDisclosureForecastingLung and intrathoracic tumorsObstetrics and gynecologyOvarian cancerOvarian cancer screeningPeer reviewPelvic inflammatory diseaseSurgerySystematic reviews ePublished: 16 December 2014 Issue Published: 16 December 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...