-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: Adolescent pap guidelines From: rmodugno@aol.com Thu Oct 26 14:53:09 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: rmodugno@aol.com: "Re: Adolescent pap guidelines" Previous message: JD Stewart,MD: "Re: TX doctor wins 2.5M peer review suit- and lost at least that" In reply to: Andrew Folley: "Re: Adolescent pap guidelines" Next in thread: Joanne Bulley, MD: "Re: Adolescent pap guidelines" Reply: Joanne Bulley, MD: "Re: Adolescent pap guidelines" Reply: Joe: "Re: Adolescent pap guidelines" -----Original Message----- From: agfolley@hotmail.com To: ob-gyn-l@dns.obgyn.net Sent: Wed, 25 Oct 2006 6:33 PM Subject: Re: Adolescent pap guidelines   My take of ACOG is to "leave those kids alone" ie they all have HPV and most of it will resolve on its own as long as we arent putting our 16-22 year olds through conizations and leeps. How many times have we seen "abnormal pap,to colpo, leads to leep or conization???" all before the age of 21?    >From: "Lynn Montgomery" <apgar10@qwest.net>  >Reply-To: ob-gyn-l@obgyn.net  >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>  >Subject: RE: Adolescent pap guidelines  >Date: Wed, 25 Oct 2006 16:21:40 -0500  >  >First of all, she is not at "quite low risk for HPV", she is at high risk  >given that she is sexually active - being recently postpartum. I have  >always adhered to the practice of doing the first pap at age 18 or when >they  >become sexually active. Given the extremely high number of abnormal paps I  >see in 14 through 18, I would not want to wait until age 21, and I live in >a  >"low risk" community. I don't think this has anything to do with lawyers,  >it has to do with the fact that the prevalence of HPV is very high and it >is  >our role to apply appropriate screening to assure that cervical lesions  >don't go undetected.  >Lynn  >  I agree with Andrew, Lynn. Since moving to NC, I have seen numerous adolescents/teens referred to me for colposcopy from the surrounding county health departments (NC is well known for their excellent county health departments). Yes, they are at risk for HPV, but not necessarily for high- risk strains?- what is the natural course of the disease - and how many of these young women are going to be subject to procedures that jeopardize the integrity of the cervix? Ofcourse you are aware of the recent studies questioning the role of LEEP as a cause of premature delivery. We need less destructive methods to treat CIN - where is the cervical equivalent of Aldara? The 3M rep can't tell me lest they lose their job. Robert Modugno MD MBA FACOG Sylva, NC (Recently saw a 40+ year old patient with stage IIIB cervical cancer- the usual stage of presentation where I trained in South Africa - was DES exposed - had not had a pap smear for years.) Next message: rmodugno@aol.com: "Re: Adolescent pap guidelines" Previous message: JD Stewart,MD: "Re: TX doctor wins 2.5M peer review suit- and lost at least that" In reply to: Andrew Folley: "Re: Adolescent pap guidelines" Next in thread: Joanne Bulley, MD: "Re: Adolescent pap guidelines" Reply: Joanne Bulley, MD: "Re: Adolescent pap guidelines" Reply: Joe: "Re: Adolescent pap guidelines"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Jul 2 04:45:00 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.