Re: FRI Re: Question about pap test frequency
From: Cesar Molina (cemolar777@gmail.com)
Thu Feb 22 10:13:41 2007
Of course I don´t have statistics support my experience. I had two cases of
CIS of cervix developing after two years of normal paps. I never saw
cervical cancer after one year prior normal control. And then ??? Two
cases of terrible desease it is not enough to yearly pap?? And more: some
studies had informed about a 30% failure in pap alone. More reasons for
yearly. In all manner the patient needs pelvic examination all the year;
what´s the problem to do a pap?
2007/1/26, Andrew Folley <agfolley@hotmail.com>:
>
> 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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