THE USE, QUALITY AND EFFECTIVENESS OF PELVIC EXAMINATION IN PRIMARY CARE FOR THE DETECTION OF GYNAECOLOGICAL CANCER

Authors

  • Feisal Hilman Faculty of Medicine, Indonesian Islamic University, Indonesia Author
  • M Alvian Subhakti Prambanan General Hospital, Indonesia Author
  • Rafik Prabowo Rokan Hulu General Hospital, Indonesia Author

DOI:

https://doi.org/10.61841/dka7h809

Keywords:

Pelvic examination, gynecological cancer, general practitioner

Abstract

Introduction: Pelvic examinations are vital for timely detection of gynecological cancers in primary care, yet discomfort can deter some women from seeking them. General practitioners face challenges in managing intimacy during exams, impacting their skills and confidence. Understanding these complexities using behavior change models like COM-B can aid in developing interventions to enhance pelvic examination uptake and address barriers in primary care settings for early cancer detection. A systematic review aims to consolidate qualitative studies on GPs' perceptions and experiences regarding pelvic exams, focusing on their role, barriers, and factors influencing GP behavior.

Methods: The researchers in this study followed the 2020 Preferred Reporting Items for Systematic Review and MetaAnalysis (PRISMA) guidelines to ensure that their work met the required standards. This was done to ensure the precision and reliability of the conclusions derived from the research.

Result: The search produced 18  results. After looking at the titles and summaries, we found 10  papers that fit our criteria. At first, we excluded several articles because they were written in review style. But after reading the full papers carefully, we included five papers in our final analysis. These papers included a cross sectional study, randomized control trial, and several guidelines.

Conclusion: Understanding and predicting healthcare provider behavior in gynecological examinations is complex. The Theory of Planned Behavior provided some insights into intentions but didn't fully explain actual behaviors, which were influenced by external factors like workload. Recommendations suggest tailored approaches for high-risk groups and aligning pelvic exams with cervical screening intervals. However, concerns arise from potential overuse of exams and the impact of fee-for-service payments. More comprehensive research is needed to guide noncervical malignancy screenings and comprehend the various factors influencing healthcare provider behavior in these clinical practices.

References

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;36(4):378-386. doi:10.1093/fampra/cmy092

Williams P, Murchie P, Bond C. Patient and primary care delays in the diagnostic pathway of gynaecological cancers: a systematic review of influencing factors. Br J Gen Pract. 2019;69(679):e106-e111. doi:10.3399/bjgp19X700781

Guirguis-Blake JM, Henderson JT, Perdue LA, Whitlock EP. Screening for Gynecologic Conditions With Pelvic Examination: A Systematic Review for the U.S. Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US); March 2017.

Melnikow J, Henderson JT, Burda BU, Senger CA, Durbin S, Soulsby MA. Screening for Cervical Cancer With High-Risk Human Papillomavirus Testing: A Systematic Evidence Review for the U.S. Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US); August 2018.

Giannella L, Ciavattini A. Screening and Early Diagnosis in Gynecological Cancers. Cancers (Basel). 2023;15(21):5152. Published 2023 Oct 26. doi:10.3390/cancers15215152

Mwaliko, Emily & Van Hal, Guido & Bastiaens, Hilde & Dongen, Stefan & Gichangi, Peter & Otsyula, Barasa & Naanyu, Violet & Temmerman, Marleen. (2021). Early detection of cervical cancer in western Kenya: determinants of healthcare providers performing a gynaecological examination for abnormal vaginal discharge or bleeding. BMC Family Practice. 22. 10.1186/s12875-021-01395-y.

Janjua, A., Smith, P., Chu, J., Raut, N., Malick, S., Gallos, I., … Clark, T. J. (2017). The effectiveness of gynaecology teaching associates in teaching pelvic examination to medical students: a randomised controlled trial. European Journal of Obstetrics & Gynecology and Reproductive Biology, 210, 58–63. doi:10.1016/j.ejogrb.2016.10.006

Rosenlund, I.M., Leivseth, L., Nilsen, I. et al. Extent, regional variation and impact of gynecologist payment models in routine pelvic examinations: a nationwide cross-sectional study. BMC Women's Health 17, 114 (2017).

https://doi.org/10.1186/s12905-017-0471-2

Tonelli M, Connor Gorber S, Moore A, Thombs BD; Canadian Task Force on Preventive Health Care. Recommendations on routine screening pelvic examination: Canadian Task Force on Preventive Health Care adoption of the American College of Physicians guideline. Can Fam Physician. 2016;62(3):211-214.

Evans, D., Goldstein, S., Loewy, A., & Altman, A. D. (2019). No. 385-Indications for Pelvic Examination.

Journal of Obstetrics and Gynaecology Canada, 41(8), 1221–1234. doi:10.1016/j.jogc.2018.12.007

Godin G, Belanger-Gravel A, Eccles M, Grimshaw J. Healthcare professionals' intentions and behaviours: a systematic review of studies based on social cognitive theories. Implement Sci. 2008;3:36.

Jacobs IJ, Menon U, Ryan A, et al. Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial [published correction appears in Lancet. 2016 Mar 5;387(10022):944] [published correction appears in Lancet. 2016 Mar 5;387(10022):944]. Lancet. 2016;387(10022):945-956. doi:10.1016/S0140-6736(15)01224-6

Downloads

Published

2023-12-28

How to Cite

Hilman, F., Subhakti, M. A., & Prabowo, R. (2023). THE USE, QUALITY AND EFFECTIVENESS OF PELVIC EXAMINATION IN PRIMARY CARE FOR THE DETECTION OF GYNAECOLOGICAL CANCER. Journal of Advanced Research in Medical and Health Science (ISSN 2208-2425), 9(12), 206-216. https://doi.org/10.61841/dka7h809

Similar Articles

1-10 of 252

You may also start an advanced similarity search for this article.