Fewer Young Women Getting Pelvic Exams,
CDC Says

Megan Brooks

June 27, 2019

Mixed messages in recent years about the value of the routine pelvic exam may have led more women to skip it.

An analysis of data over a 30-year period (1988–2017) from the National Survey of Family Growth (NSFG) showed a decreasing trend in the receipt of a pelvic examination in the past year among women aged 15 to 44 years, researchers from the National Center for Health Statistics (NCHS), part of the Centers for Disease Control and Prevention, note in a data brief published online yesterday.   

The value of the routine pelvic examination has been questioned in recent years.

The US Preventive Services Task Force (USPSTF) has concluded that the current evidence is insufficient to assess the balance of benefits and harms of performing pelvic screening exams in asymptomatic, nonpregnant adult women. And the American College of Obstetricians and Gynecologists (ACOG) now recommends pelvic examinations only when indicated by medical history or symptoms.

In their analysis, Gladys M. Martinez, PhD, and colleagues found that from 1988 through 2017, the percentage of women receiving pelvic examinations in the past 12 months decreased by 65% in young women aged 15 to 20 years, 57% in women aged 21 to 29, and 6% in women aged 30 to 44.

In 1988, a higher percentage of women 15 to 44 years received a pelvic exam in the past 12 months (65%) than at any of the other time point (53% in 2015–2017), they report.

Among women aged 15 to 20 years, receipt of a pelvic exam in the past year decreased:

  • from 42% in 1988

  • to 37% in 1995

  • to 32% in 2002

  • to 24% during the period 2006–2010

  • to 22% during the period 2011–2015

  • to 15% during the period 2015–2017

A similar pattern was seen among women aged 21 to 29 years, with pelvic exams declining over time, from:

  • 75% in 1988

  • to 69% in 1995

  • to 64%–62% for the periods 2002, 2006–2010, and 2011–2015

  • to 57% during the period 2015–2017

There was no statistically significant change over time in the percentage of women aged 30 to 44 who reported receiving a pelvic examination in the prior year.

During the most recent period (2015–2017), non-Hispanic black women (60%) were most likely to report having a pelvic examination in the last 12 months, followed by non-Hispanic white women (54%), and Hispanic women (45%). 

Undergoing a pelvic exam was more likely with increasing education level: 52% of women with less than a high school diploma; 55% of those with a high school diploma; 61% of those with some college; and 69% of those with a bachelor's degree reported getting a pelvic exam in the most recent period.

Socioeconomic status also mattered. Women with household incomes 300% or above the federal poverty level were more apt to have undergone a pelvic exam in the past year (60%) than women with household incomes below 150% of the federal poverty level (48%), and those with household incomes 150% to 299% of the federal poverty level (50%).

Women with no health insurance were less likely to have undergone a pelvic exam in the past year (39%) compared with women who had private insurance (56%), Medicaid (49%), or Medicare, military, or other government insurance (58%).

The findings are based primarily on interview data from the 10,094 women aged 15 to 44 in the 2015–2017 public-use data files from the NSFG, which gathers data on fertility, cohabitation, marriage, divorce, infertility, use of contraception, and general and reproductive health among a nationally representative sample of US women.

NCHS Data Brief 339. Published June 26, 2019. Full text

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