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abstract
Highlights
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- Participants mainly described pelvic examinations as respectful and reassuring
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- A majority incorrectly believed pelvic examinations were useful in detecting ovarian cancer
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- A majority incorrectly believed they were needed for sexually transmitted infection screening
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- A majority incorrectly believed the examinations were necessary before initiating contraception
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- Reading the guideline, fewer women planned to continue yearly pelvic examination
Routine
pelvic examinations have been a fundamental part of the annual female
examination. The 2014 American College of Physicians (ACP) guideline
recommends against routine pelvic examinations in asymptomatic,
nonpregnant, average-risk women. Our aim was to evaluate women's
attitudes and beliefs about pelvic examinations and how knowledge of the
new guidelines contributes to attitudes and beliefs. A descriptive
cross-sectional study was performed using a self-administered written
survey developed through literature review and pretested and revised on
the basis of staff suggestions. Nonpregnant women age ≥ 21 years
presenting to outpatient clinics at Mayo Clinic in Arizona or Mayo
Clinic in Rochester, Minnesota, received the survey. After being asked
about pelvic examination practices and beliefs, participants were
informed of the ACP guideline, to determine effect on attitudes and
beliefs. Demographic characteristics and pertinent medical history
questions were collected from participants. In total, 671 women who were
predominantly white, married, and educated completed surveys.
Participants described pelvic examinations as reassuring, and a majority
believed the examinations were useful in detecting ovarian cancer
(74.6%), necessary for screening for sexually transmitted infections
(STIs) (71.0%), or necessary before initiating contraception (67.0%).
After reading the 2014 ACP guideline, significantly fewer women planned
to continue yearly pelvic examinations (P < 0.001). Despite
evidence to the contrary, women believed pelvic examinations were
necessary for STI screening, contraception initiation, and ovarian
cancer detection. After education on the ACP screening guideline, fewer
women planned to continue yearly pelvic examinations.
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