Role of annual well-woman assessment reviewed

(HealthDay) -- For women, an annual assessment is an important part of medical care and should include screening, evaluation, and counseling, according to a Committee Opinion published online July 23 in Obstetrics & Gynecology.

The Committee on Gynecologic Practice of the American College of Obstetricians and Gynecologists, based in Washington D.C., reviewed the role of an annual health assessment in women's medical care.

The researchers note that the annual health assessment represents a fundamental part of medical care and is important for promotion of preventive practices, recognizing risk factors for disease, identifying medical problems, and establishing a relationship between the clinician and patient. The annual health assessment should include screening, assessments, and counseling, as well as immunizations, when necessary, based on age and risk factors. A key element of the health assessment is the physical examination, with components that may vary based on the patient's age, risk factors, and physician preference. The committee recommends that, regardless of sexual activity, speculum examinations for cervical cancer should begin at age 21 years; pelvic examinations should always be conducted in patients who report or exhibit symptoms suggestive of female genital tract, pelvic, urologic, or rectal problems; annual examinations may be modified for asymptomatic patients, without complicating medical issues, who have undergone a total hysterectomy and bilateral salpingo-oophorectomy for benign indications; breast self-awareness should be encouraged; and clinical breast examinations should be performed annually in women aged 40 years or older and every one to three years for those aged 20 to 39 years. The decision to perform any pelvic or breast examination should be made with the consent of the patient.

"An annual visit provides an excellent opportunity to counsel patients about maintaining a healthy lifestyle and minimizing health risks," the authors write.