Re: FRI Re: Question about pap test frequency
From: Andrew Folley (agfolley@hotmail.com)
Fri Jan 26 17:03:51 2007
It is a cervix I mean a service organization. ( :$ ) ######
>From: evsono@pipeline.com (art fougner, md)
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: FRI Re: Question about pap test frequency Date: Fri, 26 Jan 2007
>17:09:47 -0600
>
>American hysterization Scoiety ... that's sounds hysterical.
>
>Sorry, had to be said.
>
>Art
>
>At Fri, 26 Jan 2007, Bernard Cristalli wrote:
> >
> >And less breast cancer in HRT patients.
> >Bernard
> >
> >Le 26 janv. 07 à 21:46, Andrew Folley a écrit :
> >
> >> Precisely why the American Society of Hysterization is advocating
> >> the removal of the uterus and ovaries in all women over 30. Huge
> >> savings in not having paps and pelvics to do and much less anxiety
> >> over getting ovarian cancer.
> >>
> >>> From: "Barbara Nicol" <blnicol@ix.netcom.com>
> >>> Reply-To: ob-gyn-l@obgyn.net
> >>> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
> >>> Subject: Re: Question about pap test frequency
> >>> Date: Fri, 26 Jan 2007 09:43:39 -0600
> >>>
> >>> Dear Gail -
> >>>
> >>> Paps could go to every 3 years in a low risk patient - I see that
> >>> someone's
> >>> already forwarded at least one of the several sets of guidelines.
> >>>
> >>> Digital rectal stool guaiacs are no longer recommended - the previous
> >>> practitioner was incorrect. Too many false positives. However,
> >>> anyone
> >>> over 50 should receive colon cancer screening. The home cards
> >>> she received
> >>> are one of the 3 recommended methods.
> >>>
> >>> There is no effective screening test for ovarian cancer. What
> >>> evidence do
> >>> we really have that putting asymptomatic women through pelvic
> >>> exams finds
> >>> ovarian cancer any earlier than just waiting for symptoms? We
> >>> find it at
> >>> stage III, by and large. I think, in my more nihilistic moments,
> >>> that the
> >>> profession should question the routine policy of asking
> >>> asymptomatic women
> >>> to have bimanual exams. My impression is that we do them
> >>> because we are
> >>> thorough - sort of an attitude of "well, you're here, let's do a
> >>> complete
> >>> exam" rather than because there's evidence that a screening exam
> >>> produces
> >>> benefits in asymptomatic women.
> >>>
> >>> (Oh, yeah, and because the sympathetic jury will bankrupt us if
> >>> she shows up with ovarian cancer 2 months later, even though
> >>> there's zero evidence that we can improve outcomes once a cancer
> >>> is big enough to feel on pelvic, compared to waiting for
> >>> symptoms. But is that really an ethical reason to do the exam?)
> >>>
> >>> That said, if a woman is very worried about it, scheduling annual
> >>> exams is
> >>> fine. Heck, scheduling monthly or weekly exams would be fine, if
> >>> she wants
> >>> to pay for them and put up with them. Just don't think that
> >>> there are data
> >>> showing that this practice is of benefit in early detection of
> >>> ovarian
> >>> cancer, or in producing better outcomes. (It may help reduce
> >>> anxiety,
> >>> though - I'm not ignoring that.)
> >>>
> >>> Best,
> >>>
> >>> Barb
> >>>
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>
>--
>art fougner, md
>"May The Wings of Liberty Never Lose a Feather." - Jack Burton
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