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Re: Squamous metaplasia vs. ASC-HFrom: l.glazerman@rcn.comFri Sep 8 17:19:37 2006
The Merck vaccine covers 6/11/16/18. 6/11 are associated with 90% of genital warts, and 16/18 represent 70% of cervical CA. The question of possible increased prevalence of other strains remains to be seen. Remember that sometimes the biggest enemy of good is perfect. Sent from my Treo 700P -----Original Message----- From: "Richard D. Kaplan" <rkaplan@triad.rr.com> Subj: Re: Squamous metaplasia vs. ASC-H Date: Fri Sep 8, 2006 4:54 pm Size: 2K To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> The Merck vaccine covers only the 16/18 high risk strains of HPV. I'm concerned that after wide spread vaccinations, other high risk strains would increase in prevalence and young women would still be at risk. Is this a valid concern? Richard Kaplan, MD Greensboro, NC
>----- Original Message ----- unfortunately the same trap applies. significant numbers of sexually active young women have pos tests for HPV, Thus, you do a pap and get a positive HPV read--if it is a 16 or 18 you feel compelled to start the train to colpo, Bx or LEEP. the overwhelming majority clear within two years. but we then feel compelled to work them up because they are a 16 or 18 HPV. The numbers of under 25 , sexually active women pos for HPV approach 50%. 40.999% clear spontaneously without leep, colpo or biopsy. We need to worry about the women over age 21 who do not clear the HPV within two years. Of course all this will be moot when the pediatricians start giving the HPV vaccine. Then the days of necessary or unnecessary paps will be clearer. Some of our providers of female health care may have to find some other way to earn a living...like preventing cardiovascular disease and obesity that really does kill women. While one out of 9 may die of breast cancer, guess what most of the rest die of...it ain't cervical or ovarian or colon..it is CV disease. Less than 500 women die per year in NC from cervical....more than that die each week die from heart attack and stroke in NC. And if they are under age 21 they die from pregnancy problems, not cervical disease. The recommended practice is no pap until at least 3 years of sexual exposure or age 21. Even if they are pregnant. We cut out LEEPS and biopsying pregnant cervices in young women women a long time ago also. And no PAP for 4 months after delivery. Healing and repair look just like dysplasia on a --- message truncated ---
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