Should the Annual be every year?

The ‘yearly’ physical examination is an opportunity for the patient and physician to spend focused time on health maintenance and disease prevention. If a recommended preventive service is missed one year we can catch up at the next visit. The visit also nutures the patient-physician relationship.

For women, there are 21 measures that earn a A or a B rating as showing evidence for effectiveness in maintaining health or preventing disease.  Mammography is the 22^nd measure. What is NOT effective is an annual pelvic examination.

As we attempt to better allocate our health care dollars, we need to think about what procedures are supported by evidence and which are performed merely out of habit. There no clear reasons to perform a yearly pelvic examination in women who have no symptoms and for whom a Pap test is not due. In 2012, Pap test guidelines were resolved to recommend a standard cytology examination every three years. In women between the ages of 30-65 the testing interval can be increased to every 5 years if the HPV test (done at the same time as the Pap test) is negative. No need for testing in the asymptomatic woman after age 65.

Many women believe that that pelvic examination screens for ovarian cancer; sadly, this is not true. Also, pelvic examinations are not needed to start or continue oral contraceptives.

There is evidence that many women avoid routine care because of the dreaded pelvic examination. These women are denying themselves the chance of obtaining a personalized program to help stay well. 

Staying Healthy: Recommendations for Women