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Cervical neoplasiaFrom: Zach Newton (zbnewton@mindspring.com)Sun Dec 3 18:39:31 2000
The technological imperative of applying newly available methods to enhance resolution of obstinate problems has been the story of medical progress. Historically, the successes establish ecclesiastical glory on the humble brow of science. Great. Under the blanket resides the bones of opportunists who rode the horse of science with 666 on their racing silks. I speak to the issue of HPV typing, as applied to triage in the management of abnormal cervical cytology by routine screening. Epidemiologists, public health officers, managed care executives and government payors have an increasingly powerful database from which systemwide policies are developed and declared. Great. Then, there remains us. An abnormal report comes in. Scenarios abound in regard to the woman from whom the sample was acquired. The reporting lab has an abnormal rate that may range from 5-20%. The statistical risk for the ASCUS or LGSIL representing a more advanced process is variable, but is 5% at bottom. Abnormal cytology includes non-HPV cervical neoplasia. Am I gonna go with an HPV typing report on assessing the particular woman with an abnormal Pap at a substantial cost that will not change what I recommend? NFW.
-- Zach Newton Z. B. Newton, III, M.D. Atlanta/Gyn
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