Wellness check-ups for women can be life-saving. Early detection of cervical and breast cancer improve the chance of survival with minimal treatment, but when is the best time to have check-ups and do women really have a choice in the matter? According to the American College of Obstetricians and Gynecologists, women have a choice and if they are asymptomatic with no history of health issues related to the breasts or female reproductive system, they do have a choice in the matter of wellness exams.
Breast Exams
Breast exams, including mammograms, should be completed yearly starting at age 40. If women notice changes in breast tissue in the interim, during monthly self exams, additional testing and screening may be required. Women between 20 and 39 years of age can have breast exams every one to three years, as needed or recommended by the attending physician, but the final choice is that of the patient.
Pelvic Exams
Clinical pelvic exams should start at age 21, including annual Pap smear tests. According to ACOG, there is no clinical evidence that exams need to start before the age of 21. If there are no underlying conditions and if the patient is in the low risk category, annual exams may not be needed. ACOG suggests women discuss the need for annual pelvic exams and Pap smears with their physician to establish a schedule that best fits that individual patient.
Women who’ve undergone a total hysterectomy with the removal of the uterus, fallopian tubes and ovaries do NOT need to have annual pelvic exams if there is no history of malignancy, cancer or precancerous neoplasia. To fall into this category, women must be HIV-negative and have no immune system impairments. Diethylstilbestrol exposure in utero could change this recommendation.
If it comes to the attention of the physician that a woman would not seek treatment for medical conditions revealed by the pelvic exam or Pap smear, for varying reasons including age or health status, annual exams should remain the choice of the patient.
It is important to note that these general guidelines are not patient-specific. If there is a history of medical problems that could be detected with earlier or more frequent pelvic or breast examinations, these issues need to be discussed with the patient. ACOG, the National Comprehensive Cancer Network and the American Cancer Society all agree that the final choice remains with the patient.
Source: Committee on Gynecologic Practice. Obstetrics & Gynecology. August, 2012.