USE, QUALITY, AND EFFECT OF PELVIC EXAMINATION IN PRIMARY CARE FOR DETECTION OF GYNAECOLOGICAL CANCER: SYSTEMATIC REVIEW
Keywords:
Detection, Malignancy, Pelvic Examination, ScreeningAbstract
Clinical examination has always been seen as a vital skill for physicians. Pelvic examination (PE) includes of vulvar inspection, bimanual examination of the pelvic organs, and speculum examination of the cervix. There is evidence that the absence of PE is connected with diagnostic delay, despite the fact that the intimacies of PE make it a difficult examination for both clinicians and patients. Standards for fast referral of patients with a suspicion of cancer are one of several initiatives to reduce patient wait times and improve outcomes. Various groups created these regulations. Pelvic exams have been part of well-woman visits since ancient times. Many women and gynecologic care professionals use this session as an opportunity to discuss sexual and reproductive health issues with their patients. Hence, numerous ladies seize this opportunity. A pelvic examination is typically performed on asymptomatic women as a screening tool for gynecologic cancer, infection, and asymptomatic pelvic inflammatory disease; despite evidence to the contrary, some obstetrician–gynecologists and patients believe it is crucial for detecting subclinical disease. As a screening technique for gynecologic cancer, infection, and asymptomatic gynecologic malignancy, a pelvic examination is frequently conducted on asymptomatic women. The pelvic examination may include an appraisal of the patient's external genitalia, an examination of the patient's internal genitalia using a speculum, a rectovaginal examination, and bimanual palpation. Depending on your preferences, you can do these components individually or in combination. According to the United States Preventative Services Task Force, there are insufficient data to evaluate whether a pelvic exam accurately diagnoses a variety of gynecologic diseases. There is little data to support the idea that PE aids in the detection of gynecological cancer. PE is frequently not performed on women with gynecological cancer symptoms, and evidence that it may result in an earlier stage of diagnosis is limited. Further investigation is required.
References
International Agency for Research on Cancer. Latest Global Cancer Data. Geneva: World Health Organization’s; 2018.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020 :
GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. Vol. 71. 2021.
Thompson SD. Ovarian cancer screening: a primary care guide. Lippincotts Prim Care Pract. 1998;2(3):244–50. [4] Funston G, O’Flynn H, Ryan NAJ, Hamilton W, Crosbie EJ. Recognizing gynecological cancer in primary care: risk factors, red flags, and referrals. Adv Ther. 2018;35(4):577–89.
Collins S, Sabaratnam A, Kevin H, Simon J, Lawrence I. Oxford Handbook of Obstetrics and Gynaecology. 2013;598–9.
Williams P, Murchie P, Cruickshank ME, Bond CM, Burton CD. The use, quality and effectiveness of pelvic examination in primary care for the detection of gynaecological cancer: a systematic review. Fam Pract. 2019 Jul;36(4):378–86.
Policar MS. Current Strategies the Well-Woman Visit.
Force USPST. Screening for Gynecologic Conditions With Pelvic Examination: US Preventive Services Task Force Recommendation Statement. JAMA [Internet] 2017 Mar 7;317(9):947–53. Available from: https://doi.org/10.1001/ jama.2017.0807
Mwaliko E, Van Hal G, Bastiaens H, Van Dongen S, Gichangi P, Otsyula B, et al. Early detection of cervical cancer in western Kenya: determinants of healthcare providers performing a gynaecological examination for abnormal vaginal discharge or bleeding. BMC Fam Pract. 2021 Mar;22(1):52.
Doroudi M, Kramer BS, Pinsky PF. The bimanual ovarian palpation examination in the Prostate, Lung, Colorectal and Ovarian cancer screening trial: Performance and complications. J Med Screen. 2017 Dec;24(4):220–2.
Lim AW, Ramirez AJ, Hamilton W, Sasieni P, Patnick J, Forbes LJ. Delays in diagnosis of young females with symptomatic cervical cancer in England: an interview-based study. Br J Gen Pract J R Coll Gen Pract. 2014 Oct;64(627):e602-10.
Williams P, Murchie P, Cruickshank ME, Burton C, Bond C. What influences the performance of pelvic examination in primary care: a qualitative investigation. Br J Gen Pract [Internet] 2023 Feb 9;BJGP.2022.0363. Available from: http://bjgp.org/content/early/2023/02/08/BJGP.2022.0363.abstract
Pearse RM, Clavien PA, Demartines N, Fleisher LA, Grocott M, Haddow J, et al. Global patient outcomes after elective surgery: Prospective cohort study in 27 low-, middle- and high-income countries. Br J Anaesth. 2016;117 (5):601–9.
Ahuja C, Cron J. Pelvic Examinations in the Adolescent and Young Adult Population: A Commentary on Why and When. J Pediatr Adolesc Gynecol. 2021;34(6):783–6.
Guirguis-Blake JM, Henderson JT, Perdue LA. Periodic screening pelvic examination: evidence report and systematic review for the US Preventive Services Task Force. Jama. 2017;317(9):954–66.
Bloomfield HE, Olson A, Greer N, Cantor A, MacDonald R, Rutks I, et al. Screening pelvic examinations in asymptomatic, average-risk adult women: an evidence report for a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014;161(1):46–53.
Qaseem A, Humphrey LL, Harris R, Starkey M, Denberg TD, Physicians* CGC of the AC of. Screening pelvic examination in adult women: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014;161(1):67–72.
Guirguis-Blake JM, Henderson JT, Perdue LA, Whitlock EP. Screening for gynecologic conditions with pelvic examination: a systematic review for the US Preventive Services Task Force. 2017;
Vandborg MP, Christensen R dePont, Kragstrup J, Edwards K, Vedsted P, Hansen DG, et al. Reasons for diagnostic delay in gynecological malignancies. Int J Gynecol Cancer. 2011;21(6).
Goff BA, Mandel L, Muntz HG, Melancon CH. Ovarian carcinoma diagnosis: results of a national ovarian cancer survey. Cancer Interdiscip Int J Am Cancer Soc. 2000;89(10):2068–75.
Anorlu RI, Ribiu KA, Abudu OO, Ola ER. Cervical cancer screening practices among general practitioners in Lagos Nigeria. J Obstet Gynaecol (Lahore). 2007;27(2):181–4.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Licensing
Ninety Nine Publication publishes articles under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This licensing allows for any use of the work, provided the original author(s) and source are credited, thereby facilitating the free exchange and use of research for the advancement of knowledge.
Detailed Licensing Terms
Attribution (BY): Users must give appropriate credit, provide a link to the license, and indicate if changes were made. Users may do so in any reasonable manner, but not in any way that suggests the licensor endorses them or their use.
No Additional Restrictions: Users may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.