Bad medicine: gynaecological examinations

Thanks for the response but I must completely disagree . Firstly the
evidence that Cervical cancer is linked to vaginal discharge is
observational and case based. [1] There is no prospective data and I would
assert that discharge is so common and non specific as to be useless as a
determining risk factor for cervical cancer. Secondarily you are
extrapolating experience from secondary care without knowledge of the
prevalence of vaginal discharge in the community. Many women present to
pharmacies and take empirical treatments, should they all have speculums
too? Thirdly what is the negative predictive value for inspecting the
cervix? Your policy suggestion is utterly disproportionate inflicting
unnecessary and unpleasant investigations on millions of women with no
scientific evidence of benefit .We should move away from fearful emotive
anecdote and opinion. To limit the impact of cervical cancer in young
women we should ensure better uptake of smears and HPV vaccination for
this has evidence of benefit.

Finally my point was "routine" speculums examination for swabs
traditionally taken for endocervical sampling and is no longer necessary.
This being the medical dogma of my education. Clearly speculums have role
in women with irregular bleeding , atypical and persistent discharge but
not routinely in those presenting with discharge in primary care. Practice
should change for it is bad medicine.

[1] Referral for suspected cancer NICE, 2005