Mini Review - (2022) Volume 8, Issue 7
Received: 06-Jul-2022, Manuscript No. IPGOCR-22-14242; Editor assigned: 08-Jul-2022, Pre QC No. IPGOCR-22-14242 (PQ); Reviewed: 20-Jul-2022, QC No. IPGOCR-22-14242 (Q); Revised: 25-Jul-2022, Manuscript No. IPGOCR-22-14242 (R); Published: 01-Aug-2022, DOI: 10.36648/2471-8165.8.7.33
An established aspect of women's health care is the idea of an annual gynecologic screening visit to detect disease at an early stage. The schedule of a yearly gynecologic examination including cervical cancer screening and a pelvic examination has long been recognized by women and their medical professionals. Recently, researchers reestablished the intervals for Pap test screening with the addition of human papillomavirus co-testing to identify cervical cancer risk and questioned the relevance of the annual breast and pelvic exams in asymptomatic women. The modernized well woman exam offers women the chance to learn about health, be screened for risks of developing chronic diseases, and discuss health issues like depression and violence.
Gynecological cancer; Health cares
Health care professionals have always accepted the routine of a yearly gynecologic examination, which includes a pelvic exam and a cervical cancer screening [1]. Although they do not have the same meaning, screening and diagnostic tests are frequently used interchangeably. A diagnostic test is used to help with the diagnosis of a suspected disease or condition, whereas a screening test is intended to detect asymptomatic people who are at risk of acquiring a disease or condition. The use of the Pap test, breast exam, and pelvic exam as screening tests in asymptomatic women is the main topic of this article.
Diagnostics for cervical cancer
Recent evidence-based recommendations for cervical cancer screening call for starting the procedure at age 21 and repeating it every three years with a Pap test or every five years if cotesting for the Human Papillomavirus (HPV) is done after age 30.
Based on a deeper understanding of the nature and function of persistent HPV infection in the emergence of cervical cancer, these modifications to the customary annual screenings. For the majority of women, particularly younger ones, the virus is cleared by the immune system in a year or two. When HPV does not clear, it is concerning and needs additional monitoring [2-4]. Through HPV vaccination in adolescence, women can lower their initial risk, and doctors can lessen the burden of cervical cancer by raising screening rates among women who have undergone screening infrequently or never.
Clinicians and the women they treat have started to wonder whether the annual pelvic exams used as part of the screening programme for cervical cancer are still necessary since more stringent criteria have been implemented into daily practise. What benefits can be derived from the screening pelvic exam? If professionals don't undertake a screening pelvic check on low-risk women, might anything be missed? What proof is there that asymptomatic, low-risk women can use a pelvic exam as a disease screening test?
Pelvic examining
Technological advancements in laboratory testing have made it possible to undertake screening from a self-collected vaginal swab or urine testing for sexually transmitted illnesses that are frequently asymptomatic, such as chlamydia and gonorrhea [5]. Most sexually transmitted illnesses are now screened for without a pelvic exam. However, does the screening pelvic exam find cancer? Only late stages of cervical cancer can be detected physically, and the Pap test detects cervical cancer.
Rectal checks as part of a pelvic exam are also no longer advised for rectal cancer screening due to the development of officebased occult blood tests of stool and colonoscopy. There were no studies that evaluated the advantages of screening pelvic exams for the identification of bladder, vaginal, vulvar, uterine, or ovarian cancer or for the benign conditions of fibroids, warts, atrophic vaginitis, or pelvic inflammatory disease, according to a comprehensive review [6].
Rectal checks as part of a pelvic exam are also no longer advised for rectal cancer screening due to the development of office-based occult blood tests of stool and colonoscopy [7]. There were no studies that evaluated the advantages of screening pelvic exams for the identification of bladder, vaginal, vulvar, uterine, or ovarian cancer or for the benign conditions of fibroids, warts, atrophic vaginitis, or pelvic inflammatory disease, according to a comprehensive review.
There is a lack of evidence to support the claim that the screening pelvic exam picks up benign illnesses that a full medical history would miss. Instead of screening all women with a pelvic examination, for pelvic floor dysfunction, a straightforward screening tool was used to find women who had mild symptoms of uterine prolapse and would then benefit from a thorough pelvic examination. Before beginning a hormonal method of contraception was another reported reason for doing a pelvic exam. However, The American College of Obstetricians and Gynecologists (ACOG) stated in practise recommendations released in 2012 and updated in 2014 that hormonal contraception can be provided to low-risk women without first doing a pelvic exam.
Due to the paucity of research demonstrating the advantages of performing screening pelvic exams on adult women who are asymptomatic and not pregnant, the American College of Physicians advises against doing so. Although ACOG claims that there is no evidence in favor of or against the yearly pelvic exam, they nonetheless advise all women over the age of 21 to get one every year. In recognition of the examination's limitations, this recommendation is supported by professional opinion. A joint decision-making process for the screening is advised by ACOG.
Breast cancer detection
The American Cancer Society's most current guidelines, which gave a qualified recommendation against screening breast exams in women of any age, called into question the value of the screening breast examination. A qualified suggestion is one that has strong supporting data for benefits but less conviction regarding the relative importance of benefits and drawbacks. It's crucial to talk to women about their personal values and preferences as with any recommendation, but especially with a qualified one. Evidence-based care is defined as combining a woman's values and expectations with the best available research evidence, the clinician's clinical skill, and both.
Women now have a rare chance to get the necessary preventive screenings they need without having to contribute to the expense because to the Affordable Care Act [8]. These include well-woman visits, specifically involving HPV DNA testing, contraceptive counselling, and screening for sexually transmitted illnesses, testing and screening for HIV, blood pressure, depression, and other mental health conditions. Mammograms are one of the other preventive services every one to two years for females over 40.
Health promotion
An introduction to self-care that encourages patient engagement might be given during a woman's routine medical checkup. It's an opportunity to address preconception and contraceptive needs by introducing a reproductive life plan that asks women if they want to get pregnant within the next year. This gives pregnant women the chance to receive counselling regarding preconception care, which includes genetic screening, the evaluation of occupational health hazards, the identification of substance use, and details about the teratogenic effects of pharmaceuticals. Before conception, this kind of health advice can help ensure a healthy pregnancy.
Patient contentment
Using Lucia as an example, a detailed assessment of her medical history reveals that she is qualified for Pap and HPV co-testing every five years without a pelvic exam or breast examination at the time of her appointment today. Lucia says she prefers this strategy and appreciates the discussion of the validity or otherwise of the results of the Pap test and physical examination.
The nursing profession has a long history of challenging widely accepted care delivery practises and integrating evidence-based science into daily practise. Potentially strengthening efforts to enhance women's overall health is a critical evaluation and revision of the yearly gynecologic wellness screening. In the healthcare team, nurses and midwives are in a prime position to take the initiative to change practise protocols using the best available evidence, engage other team members in reinforcing wellness, and promote overall health.
The author has no conflicts of interest to declare.
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Citation: Merry A (2022) Updated Annual Gynecologic Exam for the 21st Century. Gynecol Obstet Case Rep. Vol.8 No.7:33.
Copyright: © Merry A. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
