Q / Do annual pelvic exams benefit asymptomatic women who receive regular Pap smears?

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Abstract

EVIDENCE-BASED ANSWER

A / No evidence exists to support a clinical benefit from annual pelvic examinations for asymptomatic women who receive Pap smears every 3 to 5 years. However, the American College of Obstetricians and Gynecologists (ACOG) committee on gynecologic practice recommends annual pelvic exams (strength of recommendation [SOR]: C, expert opinion).

EVIDENCE-BASED ANSWER

Urine testing alone reliably diagnoses gonorrhea and chlamydia (SOR: A, systematic review of cohort studies).

EVIDENCE-BASED ANSWER

Pelvic examinations unreliably detect adnexal masses (SOR: B, single cohort study); pelvic exams accompanied by ultrasound fail to affect outcomes in ovarian cancer screening (SOR: B, cohort studies).

EVIDENCE-BASED ANSWER

Pelvic exams aren't necessary before prescribing oral contraceptive pills (OCPs) (SOR: C, expert opinion).

EVIDENCE-BASED ANSWER

Vulvar carcinoma has a low prevalence and is usually symptomatic (SOR: B, ecologic study and a case series).

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