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

Abstract

Q: Do annual pelvic exams benefit asymptomatic women who receive regular Pap smears? Evidence-based answer: 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). Urine testing alone reliably diagnoses gonorrhea and chlamydia (SOR: A, systematic review of cohort studies). 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). Pelvic exams aren't necessary before prescribing oral contraceptive pills (OCPs) (SOR: C, expert opinion). Vulvar carcinoma has a low prevalence and is usually symptomatic ((SOR: B, ecologic study and a case series).