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Researchers classified the pelvic examination into two types: medically indicated or potentially unnecessary. Pelvic examinations were considered medically indicated if performed during pregnancy or in association with use of an intrauterine device, or in the context of treatment for a sexually transmitted disease.
The investigators estimated that of approximately 2.6 million young women who received a pelvic exam during the previous year, more than half (54.4 percent) were potentially unnecessary, representing an estimated 1.4 million young women.
Additionally, the researchers found that nearly a fifth of females younger than the recommended age had a Pap test within the past year. Because 72 percent were performed as "part of a routine exam," they were potentially unnecessary, representing an estimated 1.6 million young women. Almost all of the pelvic examinations were performed at the same time as the Pap test.
Young women who had been screened for a sexually transmitted infection were 3.8 times more likely to receive a Pap test and 60 percent more likely to receive a pelvic examination, compared with those who had not been screened.
Similarly, young women who used a hormonal contraception other than IUD were 75 percent more likely to receive a Pap test and 31 percent more likely to receive a pelvic examination, compared with those who did not use those contraception methods.
This study suggests that healthcare providers and young women need to communicate clearly and often about the best time for these tests. We want to ensure that guidelines are followed, and lives are saved. First author Jin Qin, ScD, an epidemiologist with the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention Source:
University of California - San Francisco Journal reference:
Qin, J. et al . (2020) Prevalence of Potentially Unnecessary Bimanual Pelvic Examinations and Papanicolaou Tests Among Adolescent Girls and Young Women Aged 15-20 Years in the United States. JAMA Internal Medicine . doi.org/10.1001/jamainternmed.2019.5727
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