Many Pelvic Exams, Pap Tests Unnecessary in Teens and Young Adults

More than half of bimanual pelvic examinations (BPEs) and more than 70 percent of Papanicolaou (Pap) tests performed among adolescent girls and women younger than 21 years in the United States are unnecessary, according to a study published online January in JAMA Internal Medicine.

Jin Qin, Sc.D., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues estimated the prevalence of potentially unnecessary BPE and Pap tests performed among adolescent girls and women in the United States. BPEs were considered potentially unnecessary if they were performed among young women who were not pregnant, did not use an intrauterine device, and did not have a sexually transmitted infection in the previous year. The authors used data from a cross-sectional sample of young women aged 15 to 20 years (3,410 young women).

The researchers found that about 22.9 percent of U.S. women aged 15 to 20 years surveyed in 2011 to 2017 reported having a BPE in the previous 12 months. Overall, 54.4 percent of these examinations were potentially unnecessary, representing an estimated 1.4 million young women. BPE receipt correlated with having a Pap test, being tested for sexually transmitted infections, and using hormonal contraception other than an intrauterine device (adjusted prevalence ratios, 7.12, 1.60, and 1.31, respectively). An estimated 19.2 percent of young women reported having received a Pap test in the previous 12 months, with 71.9 percent potentially unnecessary.

"These findings suggest the need for education for health care professionals, parents, and young women themselves to improve awareness of professional guidelines and the limitations and harms of routine pelvic examination and Pap test," the authors write.

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