Unnecessary Pap Tests Are Common, Despite Guidelines

Many women aged 15 to 20 years in the US receive unnecessary pelvic examinations and Papanicolaou (Pap) tests, despite guidelines recommending against them, according to the results of a recent study.

Guidelines no longer recommend the use of pelvic examination in asymptomatic, nonpregnant women due to potential harms, including false-positive test results, overdiagnosis, and anxiety.

To estimate the frequency of unnecessary testing in women aged 15 to 20 years, the researchers conducted a cross-sectional analysis of data from the National Survey of Family Growth from September 2011 through September 2017.

Overall, approximately 2.6 million (22.9%) of the young women surveyed reported having a pelvic examination within the last 12 months, of which 54.4% were potentially unnecessary. Further, an estimated 2.2 million (19.2%) reported receiving a Pap test within the past 12 months, of which 71.9% were 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 and to ensure that these tests and examinations are performed only when medically necessary among young women,” the researchers concluded.

—Michael Potts

Reference:

Qin J, Saraiya M, Martinez G, et al. Prevalence of potentially unnecessary bimanual pelvic examinations and papanicolaou tests among adolescent girls and young women aged 15-20 years in the United States [published online January 6, 2020]. https://doi.org/10.1001/jamainternmed.2019.5727