Re: Gyn: Cervical Cancer Screening
From: FRANCES WREN (fwren@shaw.ca)
Mon Jan 14 12:38:50 2008
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I thought that the majority of thr LSIL paps are lo risk HPV..
am I wrong.
I just usually follow them ...certainly in the younger women.the older ones I worry about and am more aggressive.
frances wren
>----- Original Message -----
From: evsono@pipeline.com (art fougner, md)
Date: Saturday, January 12, 2008 11:57 am
Subject: Re: Gyn: Cervical Cancer Screening
To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
> 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
>
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<DIV>I thought that the majority of thr LSIL paps are lo risk HPV..</DIV>
<DIV>am I wrong.</DIV>
<DIV>I just usually follow them ...certainly in the younger women.the older ones I worry about and am more aggressive.</DIV>
><DIV>frances wren<BR><BR>----- Original Message -----<BR>From: evsono@pipeline.com (art fougner, md)<BR>Date: Saturday, January 12, 2008 11:57 am<BR>Subject: Re: Gyn: Cervical Cancer Screening<BR>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net><BR><BR>> For your viewing pleasure, the ASSCP 2007 consensus guidelines <BR>> may be<BR>> seen here:<BR>> http://nmanet.org/index.php?/video/index/your_practice_and_the_2007_accp<BR>> <BR>> Art<BR>> <BR>> At Sat, 12 Jan 2008, Larry Glazerman wrote:<BR>> ><BR>> >I think the argument here is one of cost-effectiveness. Since <BR>> the ALTS<BR>> >trial showed that >80% of LSIL paps will be HRHPV positive, <BR>> it's more<BR>> >cost effective to colpo all LSIL (to find the occasional cervix that<BR>> >actually has a HSIL), than to do HRHPV on ALL LSILs, and then colpo<BR>> >the 80% that are HRHPV positive.<BR>> ><BR>> >ASCUS is a different story. Since the prevalence of HRHPV in <BR>> the ASCUS<BR>> >population is much lower (I quote around 20%), then doing HRHPV <BR>> on all<BR>&
gt; >ascus makes sense - forget about the ones who are HRHPV <BR>> negative, and<BR>> >colpo the ones who are positive.<BR>> ><BR>> >Having said that, IF I were in the position that I knew I had a<BR>> >patient with LSIL and negative HRHPV, I might not colpo her, as you<BR>> >suggest.<BR>> ><BR>> >--<BR>> >Larry R. Glazerman, MD, FACOG<BR>> >St. Luke's Center for Advanced Gynecologic Care<BR>> >250 Cetronia Road<BR>> >Suite 305<BR>> >Allentown PA 18104<BR>> >484-223-3279<BR>> >484-223-2830 FAX<BR>> >glazerl@slhn.org<BR>> ><BR>> >On Jan 12, 2008, at 11:04 AM, <rchudacoff@mylinuxisp.com> <BR>> <rchudacoff@mylinuxisp.com> > wrote:<BR>> ><BR>> >> and my thought is why do a colpo on ASCUS or LGSIL abscence <BR>> of HR HPV?<BR>> >><BR>> >> Richard Chudacoff, MD, FACOG<BR>> >> -sent from my Treo 650<BR>> >
><BR>> >> -----Original Message-----<BR>> >><BR>> >> From: Larry Glazerman <l.glazerman@rcn.com><BR>> >> Subj: Re: Gyn: Cervical Cancer Screening<BR>> >> Date: Fri Jan 11, 2008 6:06 pm<BR>> >> Size: 1K<BR>> >> To: Multiple recipients of list OB-GYN-L <ob-gyn-<BR>> l@dns.obgyn.net>>><BR>> >> Yes, HPV 6 and 11 have been known to cause LGSIL, but <BR>> virtually NEVER<BR>> >> HGSIL. Therefore the LGSIL that might be caused by 6 and 11 <BR>> is even<BR>> >> less concerning than that caused by 16-18 (which most of us <BR>> wouldn't>> treat anyway.<BR>> >><BR>> >> If I were a betting man, or lived in Las Vegas, I wouldn't do HRHPV<BR>> >> testing on a LGSIL.<BR>> >><BR>> >> Larry R. Glazerman, MD, FACOG<BR>> >> St. Luke's Center for Advanced Gynecologic Care�
60;BR>> >> 250 Cetronia Road<BR>> >> Suite 305<BR>> >> Allentown PA 18104<BR>> >> 484-223-3279<BR>> >> 484-223-2830 FAX<BR>> >> glazerl@slhn.org<BR>> >><BR>> >> On Jan 11, 2008, at 4:06 PM, Richard Chudacoff wrote:<BR>> >><BR>> >>> I never assume anything and it had kept me out of trouble do far.<BR>> >>> Are you<BR>> >>> telling me that a low risk HPV cannot cause LGSIL?<BR>> >>><BR>> >>> Richard Chudacoff, MD, FACOG<BR>> >>> -----Original Message-----<BR>> >>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On <BR>> Behalf Of<BR>> >>> Small,<BR>> >>> Jennifer<BR>> >>> Sent: Friday, January 11, 2008 10:15 AM<BR>> >>> To: Multiple recipients of list OB-GYN-L<BR>> >>&
;gt; Subject: RE: Gyn: Cervical Cancer Screening<BR>> >>><BR>> >>> LSIL in a woman over 21 assumes HR HPV. She should go <BR>> to Colpo.<BR>> >>> Probably will be CIN I and no treatment indicated, but...<BR>> >>><BR>> >>> Jennifer Small, MSN,WHNP<BR>> >>><BR>> >>> -----Original Message-----<BR>> >>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On <BR>> Behalf Of<BR>> >>> rchudacoff@mylinuxisp.com<BR>> >>> Sent: Thursday, January 10, 2008 7:36 PM<BR>> >>> To: Multiple recipients of list OB-GYN-L<BR>> >><BR>> >> --- message truncated ---<BR>> >><BR>> <BR>> --<BR>> art fougner, md<BR>> "May The Wings of Liberty Never Lose a Feather." - Jack Burton<BR>> </DIV>
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