Human Reproduction Update Advance Access originally published online on June 10, 2004
Human Reproduction Update 2004 10(5):449-452; doi:10.1093/humupd/dmh031
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Are routine breast and pelvic examinations necessary for women starting combined oral contraception?
1 Lothian Health Family Planning and Well Woman Services, 18 Dean Terrace, Edinburgh EH4 1NL, 2 Department of Obstetrics and Gynaecology, University of Edinburgh and 3 Department of Public Health Policy, School of Hygiene and Tropical Medicine, University of London, London, UK
4 To whom correspondence should be addressed. Email: ascott{at}doctors.org.uk
Millions of women worldwide use combined oral contraception (COC). Most of them are in good health and have no contraindications to using any contraceptive method. Although extremely safe for the vast majority of women and even though the absolute risk of complications is very small, COC is associated with an increased relative risk of serious conditions including cardiovascular disease and breast and cervical cancer. In many countries, breast and pelvic examinations are routinely undertaken annually for all women using hormonal contraception. Breast and pelvic examination have low detection rates for abnormality and may yield clinically irrelevant results, causing anxiety and inconvenience to the patient for no obvious gain. There is no good evidence to support routine breast or pelvic examination either for women starting hormonal contraception or for monitoring long-term use.
Key words: breast / contraception / hormonal / pelvic / screening