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- Page navigation anchor for RE: Delays in diagnosis of young females with symptomatic cervical cancer in England: an interview-based studyRE: Delays in diagnosis of young females with symptomatic cervical cancer in England: an interview-based studyThank you for an interesting paper which highlights the role of cervical visualisation in the timely diagnosis of cervical cancer and suggests that some GPs may forego pelvic examination (PE) despite the presence of abnormal vaginal bleeding. Urgent suspected cancer referral guidelines all advocate pelvic examination prior to referral, while work by Vandborg et al, 2011 has shown that performance of PE by the GP prior to referral shortens the length of diagnostic delay.1
I recently heard this story from a male medical student who had just completed his primary care attachment. During a supervised surgery, a patient presented with a gynaecological condition. He advised the patient, as he was unable to do the required PE the supervising female GP would do it instead. The GP responded by stating that no PE was required as the patient would be referred to secondary care regardless of whether an examination took place or not.
I cannot think of any other body system that a GP would not examine prior to referral. Pelvic examination is more difficult than say placing a stethoscope on a patient’s chest in terms of time, chaperone requirements, issues of embarrassment for patients etc but I find it difficult to accept that the way we deal with these difficulties is to not do it. History provides the majority of referral information but examination is vitally important in how we determine the nature of referral, routine or urgent, and how it is tr...
Show MoreCompeting Interests: None declared.