Date of Award

5-2019

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Russ Kauffman

Second Advisor

Daryl Sieg

Keywords

bimanual pelvic examination, pelvic exam, ovarian cancer screening, CA-125, transvaginal ultrasounds, gynecological screening, adnexal mass, asymptomatic women

Abstract

There is discrepancy amongst organizations and the medical community whether bimanual pelvic examinations should be performed in asymptomatic women for routine screening. The purpose of this literature review was to determine whether bimanual pelvic examinations are beneficial for screening for ovarian cancer in comparison to no screening. In addition, research was conducted to see if healthcare providers’ professional beliefs align with the evidence and national recommendations, to determine women’s thoughts and beliefs regarding pelvic examinations, and if bimanual pelvic exams are not a valid screening tool for ovarian cancer, what are other screening methods available. Throughout reviewing peer reviewed articles and high-quality evidence, it was found that bimanual pelvic exams have low sensitivity for screening, which is not ideal due to false positives; however, several researchers still feel this is an important screening tool. Also, many providers still feel the pelvic exam is beneficial when performed annually on asymptomatic women as part of a well-woman exam and continue to perform them routinely in the office. Research also shows that the majority of women do not feel uncomfortable or pain during a pelvic exam and the majority wish to continue having them performed on a regular basis. Combinations of different screening methods such as pelvic examination with serum CA-125 annually and serum CA-125 with transvaginal ultrasound annually were found to be effective in screening for ovarian cancer in asymptomatic women.

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