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Abstract
OBJECTIVE: Less-than-annual
cervical cancer screening is now recommended for most US women, raising
questions about the need for routine annual bimanual pelvic
examinations. Little is known about clinicians' bimanual pelvic
examination practices, their beliefs about its importance, or the
reasoning underlying its performance in asymptomatic women.
STUDY DESIGN: We
conducted a nationwide survey of US obstetrician-gynecologists.
Respondents (n = 521) reported their examination practices and beliefs
based on vignettes for asymptomatic women across the lifespan.
RESULTS: Nearly
all obstetrician-gynecologists perform bimanual pelvic examinations in
asymptomatic women across the lifespan, although it is viewed as less
important for a newly sexually active 18-year-old. Reasons cited as very
important included adherence to standard medical practices (45%),
patient reassurance (49%), detection of ovarian cancer (47%), and
identification of benign uterine (59%) and ovarian (54%) conditions.
CONCLUSION: Obstetrician-gynecologists
perform bimanual pelvic examinations in the vast majority of
asymptomatic women, but the importance placed on the examinations and
reasons for conducting them vary.
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