MacLaughlin Kathy L, Faubion Stephanie S, Long Margaret E, Pruthi Sandhya, Casey Petra M
Department of Family Medicine, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA.
Womens Health (Lond). 2014 Jul;10(4):373-84. doi: 10.2217/whe.14.30.
The value of pelvic examination for healthy asymptomatic women has been called into question given the lack of benefit for ovarian and endometrial cancer screening, the ability to screen for sexually transmitted infections without a pelvic examination, and the uncoupling of the procurement of contraception with a pelvic examination. Still, there are indications for performing pelvic examinations in symptomatic women and in some high risk women. How do we as clinicians apply current evidence and expert opinion to our medical practice? Our recommendation to consider a pelvic examination at 3-5-year intervals with cervical cancer screening to elicit gynecologic and sexual health concerns offers a compromise between continuation of unnecessary annual pelvic examinations and complete elimination of these examinations.
鉴于盆腔检查对卵巢癌和子宫内膜癌筛查缺乏益处、无需盆腔检查即可筛查性传播感染以及获取避孕措施与盆腔检查脱钩,健康无症状女性盆腔检查的价值受到质疑。然而,对于有症状的女性和一些高危女性,仍有进行盆腔检查的指征。作为临床医生,我们如何将当前的证据和专家意见应用于医疗实践呢?我们建议每3至5年结合宫颈癌筛查进行一次盆腔检查,以发现妇科和性健康问题,这在继续进行不必要的年度盆腔检查和完全取消这些检查之间提供了一种折衷方案。