A recent survey showed that almost 80% of US physicians believed a pelvic exam is a useful screening tool for detecting gynecologic cancers.¹ The data, as critically assessed by the USPSTF, does not support this point of view. In fact, there is little evidence that supports using pelvic exams for screening at all. No study has shown that pelvic exams decrease mortality or disease-specific morbidity for any illness. For instance, for ovarian cancer, studies have shown that the pelvic exam has poor sensitivity for picking up ovarian cancer (<5%) and has poor specificity which leads to unnecessary surgery with consequent morbidity from surgical complications. The draft recommendations of the USPSTF are consistent with the recent recommendations of the American College of Physicians, endorsed by AAFP recommending that screening pelvic exams not be performed in asymptomatic average-risk women. The ACOG Well-Woman Task Force in 2015 recommended that an external exam may be performed annually but that the decision to perform speculum and bimanual exams for screening should be a shared informed decision between patient and clinician. ACOG noted that a pelvic exam is not necessary to prescribe birth control. Previous USPSTF and ACOG recommendations have addressed changes in pap smears for cervical cancer screening from annually to starting at age 21 every 3 years and then every 5 years after age 30, as well as urine-based screening for chlamydia and gonorrhea.^2,3 Again, worth reinforcing, this discussion applies to using pelvic to screen for disease, not as a diagnostic part of the physical exam performed for a clinically-indicated reason. —Neil Skolnik, MD