Re: Gyn: Cervical Cancer Screening
From: art fougner, md (evsono@pipeline.com)
Sat Jan 12 12:56:50 2008
For your viewing pleasure, the ASSCP 2007 consensus guidelines may be
seen here:
http://nmanet.org/index.php?/video/index/your_practice_and_the_2007_accp
Art
At Sat, 12 Jan 2008, Larry Glazerman wrote:
>
>I think the argument here is one of cost-effectiveness. Since the ALTS
>trial showed that >80% of LSIL paps will be HRHPV positive, it's more
>cost effective to colpo all LSIL (to find the occasional cervix that
>actually has a HSIL), than to do HRHPV on ALL LSILs, and then colpo
>the 80% that are HRHPV positive.
>
>ASCUS is a different story. Since the prevalence of HRHPV in the ASCUS
>population is much lower (I quote around 20%), then doing HRHPV on all
>ascus makes sense - forget about the ones who are HRHPV negative, and
>colpo the ones who are positive.
>
>Having said that, IF I were in the position that I knew I had a
>patient with LSIL and negative HRHPV, I might not colpo her, as you
>suggest.
>
>--
>Larry R. Glazerman, MD, FACOG
>St. Luke's Center for Advanced Gynecologic Care
>250 Cetronia Road
>Suite 305
>Allentown PA 18104
>484-223-3279
>484-223-2830 FAX
>glazerl@slhn.org
>
>On Jan 12, 2008, at 11:04 AM, <rchudacoff@mylinuxisp.com> <rchudacoff@mylinuxisp.com
> > wrote:
>
>> and my thought is why do a colpo on ASCUS or LGSIL abscence of HR HPV?
>>
>> Richard Chudacoff, MD, FACOG
>> -sent from my Treo 650
>>
>> -----Original Message-----
>>
>> From: Larry Glazerman <l.glazerman@rcn.com>
>> Subj: Re: Gyn: Cervical Cancer Screening
>> Date: Fri Jan 11, 2008 6:06 pm
>> Size: 1K
>> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>>
>> Yes, HPV 6 and 11 have been known to cause LGSIL, but virtually NEVER
>> HGSIL. Therefore the LGSIL that might be caused by 6 and 11 is even
>> less concerning than that caused by 16-18 (which most of us wouldn't
>> treat anyway.
>>
>> If I were a betting man, or lived in Las Vegas, I wouldn't do HRHPV
>> testing on a LGSIL.
>>
>> Larry R. Glazerman, MD, FACOG
>> St. Luke's Center for Advanced Gynecologic Care
>> 250 Cetronia Road
>> Suite 305
>> Allentown PA 18104
>> 484-223-3279
>> 484-223-2830 FAX
>> glazerl@slhn.org
>>
>> On Jan 11, 2008, at 4:06 PM, Richard Chudacoff wrote:
>>
>>> I never assume anything and it had kept me out of trouble do far.
>>> Are you
>>> telling me that a low risk HPV cannot cause LGSIL?
>>>
>>> Richard Chudacoff, MD, FACOG
>>> -----Original Message-----
>>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>>> Small,
>>> Jennifer
>>> Sent: Friday, January 11, 2008 10:15 AM
>>> To: Multiple recipients of list OB-GYN-L
>>> Subject: RE: Gyn: Cervical Cancer Screening
>>>
>>> LSIL in a woman over 21 assumes HR HPV. She should go to Colpo.
>>> Probably will be CIN I and no treatment indicated, but...
>>>
>>> Jennifer Small, MSN,WHNP
>>>
>>> -----Original Message-----
>>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>>> rchudacoff@mylinuxisp.com
>>> Sent: Thursday, January 10, 2008 7:36 PM
>>> To: Multiple recipients of list OB-GYN-L
>>
>> --- message truncated ---
>>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
