Readers React: In defense of annual pelvic exams

To the editor: Just recently, the American College of Physicians (an organization of internists and general practitioners) issued a statement suggesting that annual pelvic exams are unnecessary because there is no evidence that they save lives. (“Routine pelvic exam should be discontinued, physicians group says,” June 30)

Since when is mortality the criterion for medical intervention?

As a practicing gynecologist for more than 30 years, here are some conditions I have encountered in the course of my routine annual pelvic exams: precancerous lesions of the vulva and cervix, sexually transmitted diseases, vaginal infections, fibroids, ovarian cancer and benign ovarian tumors that required removal.

Although a few of these were in women with specific symptoms, most of these findings were in asymptomatic women or in women whose symptoms were so mild that the patient didn’t think they were important.

Pelvic examinations are an integral part of a thorough physical examination, which should be accompanied by age-appropriate screening tests. Preventive medicine works, and we shouldn’t undermine it.

Paula Bernstein, MD, Los Angeles