Medical questions & health advice by board certified doctors
"Should women have routine ultrasounds?"
How often is right for women to have a transvaginal ultrasound? In my experience this procedure is used infrequently, but couldn't we have them at the same time as a pap smear? It seems worth it if we catch diseases before they progress.
Transvaginal ultrasounds are one of many types of tests which can find abnormalities even if someone does not have symptoms. This would be an example of a screening test. Mammograms and colonoscopies are examples of screening tests that we do routinely in people at certain ages and with people with a higher chance of disease. There is much controversy over what types and when certain screening tests should be done. Recently, the United States Preventative Task Force recommended that women between the ages of 40 and 50 should not get mammograms unless they have a family history of breast cancer. The reason for these controversies is the cost benefit ratio of these tests. In women who have pelvic or GYN symptoms, it makes sense to look with an ultrasound for a problem causing those symptoms. The problem with doing ultrasounds on women without symptoms is the false positive phenomenon. A false positive is when something is found on a test, but there really is not problem. Here is an example. If we scan 1000 women without symptoms, we are likely to find 50 abnormalities only 2 of which are a life threatening problem. This means that we would have to subject 1000 women to scans, 48 women to painful and perhaps dangerous biopsies, to help 2 people (I made up these numbers by the way, but this is the idea). This means that 48 of those women were false positives. It has beens shown that many of these types of screening tests do not change outcomes in the end. I suggest that you schedule an appointment with your primary care physician. You can discus all the recommended preventative tests needed for women in your age group, with your past medical history, and your family history.
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