THE ANNUAL PELVIC EXAM, OR IS IT? DO CURRENT PAP GUIDELINES PUT PATIENTS AT RISK?

1200 – 1250

Dianna Wachtel, DHSc, PA-C, CCPA

Description

When you tell your patient she doesn’t need a PAP test (cervical cancer screening) for 3 years, does she still need a pelvic exam in the interim?

Although the Canadian Task Force on Preventative Health Care (CTFPHC) and the America College of Physicians (ACS) no longer recommend annual pelvic examination, the American College of Obstetrics and Gynaecology (ACOG) still does. What is our responsibility to our patients to make sure they have adequate health screenings? While the CTFPHC and ACP cite reasons not to do the exams, namely fear, pain, embarrassment, and of course (as with digital rectal exams with men), potential over-diagnosis and unnecessary treatment; ACOG recommends the exam, but admits there is little evidence supporting its utility in detection of pathology in asymptomatic women.

How then do we find balance in following clinical guidelines and keeping our patients healthy?

The presentation will also cover male PAP tests and include discussion of screening guidelines, including special cases, necessary health education for both providers, women and men, and pathology missed by lack of pelvic exams (cases).

Learning Objectives

At the conclusion of this session, the participant will be able to:
1. Differentiate between the current PAP test guidelines in pre-, post-menopausal and trans men and women.
2. Describe the difference between “PAP” and “pelvic exam”.
3. Investigate various pathologies (e.g. vulvar lesions, ovarian tumors, etc.) that may be missed if gynecological exams are not performed.
4. Prepare patient education supporting gynecological symptom evaluation.

PRESENTATION

Posted in: Sunday, October 21, 2018