title: Routine pelvic examinations: A descriptive cross-sectional survey of women's attitudes and beliefs after new guidelines.
abstract: Routine pelvic examinations have been a fundamental part of the annual female examination. The 2014 American College of Physicians (ACP) guideline recommends against routine pelvic examinations in asymptomatic, nonpregnant, average-risk women. Our aim was to evaluate women's attitudes and beliefs about pelvic examinations and how knowledge of the new guidelines contributes to attitudes and beliefs. A descriptive cross-sectional study was performed using a self-administered written survey developed through literature review and pretested and revised on the basis of staff suggestions. Nonpregnant women age≥21years presenting to outpatient clinics at Mayo Clinic in Arizona or Mayo Clinic in Rochester, Minnesota, received the survey. After being asked about pelvic examination practices and beliefs, participants were informed of the ACP guideline, to determine effect on attitudes and beliefs. Demographic characteristics and pertinent medical history questions were collected from participants. In total, 671 women who were predominantly white, married, and educated completed surveys. Participants described pelvic examinations as reassuring, and a majority believed the examinations were useful in detecting ovarian cancer (74.6%), necessary for screening for sexually transmitted infections (STIs) (71.0%), or necessary before initiating contraception (67.0%). After reading the 2014 ACP guideline, significantly fewer women planned to continue yearly pelvic examinations (P<0.001). Despite evidence to the contrary, women believed pelvic examinations were necessary for STI screening, contraception initiation, and ovarian cancer detection. After education on the ACP screening guideline, fewer women planned to continue yearly pelvic examinations.
authors.affiliation: Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, United States. Electronic address: kling.juliana@mayo.edu.
authors.forename: Juliana M
authors.initials: JM
authors.lastname: Kling
authors.affiliation: Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, United States.
authors.forename: Suneela
authors.initials: S
authors.lastname: Vegunta
authors.affiliation: Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, United States.
authors.forename: Mina
authors.initials: M
authors.lastname: Al-Badri
authors.affiliation: Division of General Internal Medicine, Mayo Clinic, Rochester, MN, United States.
authors.forename: Stephanie S
authors.initials: SS
authors.lastname: Faubion
authors.affiliation: Division of Community Internal Medicine, Mayo Clinic, Scottsdale, AZ, United States.
authors.forename: Heather E
authors.initials: HE
authors.lastname: Fields
authors.affiliation: Division of Community Internal Medicine, Mayo Clinic, Scottsdale, AZ, United States.
authors.forename: Amit A
authors.initials: AA
authors.lastname: Shah
authors.affiliation: Division of Community Internal Medicine, Mayo Clinic, Scottsdale, AZ, United States.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Wallace
authors.affiliation: Division of Community Internal Medicine, Mayo Clinic, Scottsdale, AZ, United States.
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Ruddy
authors.affiliation: Department of Family Medicine, Mayo Clinic, Scottsdale, AZ, United States.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Bryan
authors.affiliation: Department of Biostatistics, Mayo Clinic, Scottsdale, AZ, United States.
authors.forename: M'hamed
authors.initials: M
authors.lastname: Temkit
authors.affiliation: Department of Family Medicine, Rochester, MN, United States.
authors.forename: Kathy L
authors.initials: KL
authors.lastname: MacLaughlin
mesh_terms: D000328:Adult; D003267:Contraception / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D017408:Guidelines as Topic; D058869:Gynecological Examination; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000517:prevention & control; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D011795:Surveys and Questionnaires; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D016387:Women's Health
keywords: Pap smears; Patient education; Screening pelvic examination