Diagnosis & Tests
A pelvic examination is the main physical exam used by healthcare providers to feel and see if your pelvic organs are in good health. During a pelvic exam, your healthcare provider will check your reproductive system for masses, growths or other abnormalities. This includes examining your vulva, vagina, cervix, uterus, rectum, pelvis, and ovaries.
Although an annual pelvic examination has generally been part of a woman’s routine health care, recent recommendations state there is little evidence that this examination helps detect disease. If you are having symptoms, your healthcare provider will perform this examination, but if you have no symptoms or risk factors for disease, you may not need a pelvic examination as part of your routine care.
A Pap test, or Pap smear, is a test done to screen women for cervical cancer. For this test, your healthcare provider will take a swab of the tissue inside of your cervix. 10-15% of cervical cancers are diagnosed in women over the age of 65. However, cervical cancer is rare in older women who have been screened with Pap tests in the past. If you have been screened regularly (every 3-5 years) in the past, and have never had an abnormal test, you can stop having Pap tests after the age of 65 since the risk of cervical cancer is very low. You also don’t need a Pap test if you have had a hysterectomy for a reason other than cancer. However, if you have never had a Pap test, you should be screened even if you are over the age of 65. (Also see Prevention.)
A mammogram is an X-ray of the breast that is done most often to screen women for breast cancer. A mammogram may also be done if you or your healthcare provider notice any unusual lumps in your breasts or armpits. Current guidelines recommend that women aged 50-75 get a mammogram to screen for breast cancer every 2 years. After age 75, the benefits of screening mammograms are less clear. You should talk to your healthcare provider about whether you should continue getting this test. Women who are in poor health and not expected to live for at least 10 more years should not get a mammogram because they are more likely to be harmed rather than helped by unnecessary testing and treatment. (Also see Prevention.)
It is important to remember that, over years of getting screening mammograms, many women will have an abnormal test at some time. If an abnormal area is seen on the mammogram, you will usually have another mammogram to look more closely at the specific area. You may also have an ultrasound of the breast, and a biopsy to see if the cells are cancer cells or are benign (the medical term for not harmful/malignant).
Women used to be encouraged to do a breast self-exam every month to check for any unusual lumps or changes in the breasts. However, studies have not shown that breast self-examination provides any benefit in diagnosing breast cancer or improving survival from breast cancer, so it is no longer recommended.
Last Updated August 2020