Ann Intern Med. 2015 Oct 6;163(7):537-47. doi: 10.7326/M15-1220.
Pelvic examinations have historically been a part of regular preventive care. However, because women can now be screened for cervical cancer at intervals up to every 5 years, the question of whether women need to be seen annually for routine pelvic examinations has arisen. In July 2014, the American College of Physicians (ACP) issued a guideline presenting the available evidence on screening for pathologic conditions using pelvic examination in adult, asymptomatic women at average risk. The American College of Obstetricians and Gynecologists (ACOG) Committee on Gynecologic Practice had previously issued a committee opinion in August 2012 on the need for annual examinations and provided guidelines on important elements of this procedure, including when to examine asymptomatic women. ACOG reaffirmed its initial position after publication of the ACP guideline. The guidelines differ-the ACP guideline recommends against and the ACOG committee opinion recommends in favor of routine annual pelvic examination. This paper summarizes a discussion between an internist and a gynecologist on how they would balance these recommendations in general and what they would suggest for an individual patient.
盆腔检查历来是常规预防保健的一部分。然而，由于现在可以每隔 5 年对女性进行宫颈癌筛查，因此出现了女性是否需要每年进行常规盆腔检查的问题。2014 年 7 月，美国医师学院（ACP）发布了一项指南，介绍了使用盆腔检查对平均风险的成年无症状女性进行病理性疾病筛查的现有证据。美国妇产科医师学会（ACOG）妇产科实践委员会曾在 2012 年 8 月就年度检查的必要性发表了委员会意见，并就该程序的重要内容提供了指导方针，包括何时检查无症状女性。ACOG 在发布 ACP 指南后重申了其最初立场。这些指南存在差异——ACP 指南建议反对，而 ACOG 委员会意见建议赞成常规年度盆腔检查。本文总结了内科医生和妇科医生之间的一次讨论，内容是他们将如何在总体上平衡这些建议，以及他们将对个别患者提出哪些建议。
