Much has been written recently about whether the annual pelvic exam is necessary. Many women fail to get annual pelvic exams after hearing that annual pap smears are not necessary. Keep in mind that the Pap smear only detects cervical cancer not other malignancies that can occur in women.
The risks of female cancers increases with age and pelvic exams can sometimes detect cancer at its earliest stages.
Ovarian cancer can occur at any age, but it’s most common in women over the age of 50, with about 50% developing this disease after the age of 63!. The current lifetime risk of developing ovarian cancer is 1 in 78. About 22,000 women are diagnosed with this condition annually. Sometimes ovarian disease is asymptomatic and is detected by a careful history and a annual pelvic examination.
Cancer of the uterus is far more common than ovarian cancer occurring in 3% of women during their lifetime. About 61,000 cases of uterine were diagnosed in 2018. Cancer of the uterus can be diagnosed with a pelvic exam in conjunction with a vaginal ultrasound and endometrial biopsy.
Although relatively uncommon, both vulvar (melanoma, squamous) and vaginal cancers can be diagnosed by a pelvic exam.
Besides detecting cancer, other gynecologic concerns can be addressed at the time of an annual pelvic exam including sexual dysfunction, vaginal dryness, and menopausal symptoms. Urinary symptoms can be addressed as well as screening for STD’s.
Despite recent articles suggesting that the annual pelvic is questionably necessary, I would argue just the opposite. I believe that the annual exam gives gynecologists not only the opportunity to diagnose multiple conditions that might be missed should women not have this important visit.