The Centers for Disease Control and Prevention (CDC) has released a new analysis that may be a benchmark for women’s behavior regarding pelvic exams before the American College of Obstetricians and Gynecologists (ACOG) made a sea change in guidance on when to perform the tests. Published in an NCHS Data Brief, the report spans a 19-year period and reveals trends in compliance with annual testing related to patient age, race, and socioeconomic status.
Published in an NCHS Data Brief, the report is based on interview data from more than 10,000 women aged 15 to 44 in the National Survey of Family Growth (NSFG). The NSFG is a nationally representative survey of US men and women aged 15 to 44 designed to gather data on fertility, cohabitation, marriage, divorce, infertility, use of contraception and general and reproductive health.
The authors looked at trends overall and by age from 1988 to 2017 in receipt of pelvic exams in the past year and differences by Hispanic origin and race, education, poverty status, and health insurance status for 2015 to 2017. Percentages were compared using two-tailed ttests at the 0.05 level and no adjustments were made for multiple comparisons.
In 2012, ACOG issued a Committee Opinion recommending annual pelvic exams for women aged 21 and over as part of the well-woman visit. The guidance was changed in 2018, when the organization issued a Committee Opinion advising that the test be performed when indicated by medical history or symptoms.
The key findings of the CDC analysis are as follows:
- Women aged 15 to 44 in 1998 were more likely to have undergone a pelvic exam than women at any later NSFG study period.
- The decrease in receipt of pelvic exams occurred primarily in women aged 15 to 29.
- From 1988 to 2017, the percentage of women who said they had received a pelvic exam in the past 12 months fell by 65% in the 15-to-20 age group, 57% in the 21-to-29 age group, and 6% in those aged 30 to 44.
- Non-Hispanic black women were most likely to have had a pelvic exam in the past 12 months (59.5%), followed by non-Hispanic white women (53.8%), and Hispanic women (45.4%).
- Only 38.9% of women polled from 2015 to 2017 who had no health insurance were likely to have had a pelvic exam, versus 56.2% of those with private insurance, 49.1% with Medicaid, and 58.1% of women who had Medicare, military, or other government insurance.
- Likelihood of getting a pelvic exam increased with educational level, with 68.7% of women who had a bachelor’s degree saying they had the test versus 51.5% of those with less than a high school diploma.