I agree with your screening guidelines, except I don't think there's much
value (or data) to support reflex HPF on LGSIL, either on a clinical basis
or cost effectiveness. Well over 80% of LGSIL will be positive for high-risk
HPV.
--
Larry R. Glazerman, MD
Ob-Gyn at Trexlertown, PC
610-402-0161
l.glazerman@rcn.com
_____
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Myer S.
Bornstein
Sent: Sunday, February 26, 2006 8:56 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Sexual abuse was Spanking babies
I still do papa every year on sexually active patients, My population
changes partners very often, and I have a large number of teenagers with CIN
2-3. I also do reflex testing on all ASCUS and LGSIL Paps to weed out those
who can be followed with a pap smear. The GUIDELINES, people have to
remember are based on evidence based medicine which is population based,
therefore you need to know when to deviated based on your patient and their
risks.
Myer
Myer S. Bornstein, MD, MMM, FACOG, FACPE
_____
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
GA12L@aol.com
Sent: Sunday, February 26, 2006 8:09 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Sexual abuse was Spanking babies
In a message dated 26/02/2006 13:01:54 GMT Standard Time, LCLEMOS@aol.com
writes:
even if sexually active?
Not even then. Cervical cancer is rare in women under 20. Teenagers'
bodies, particularly the cervix, are still developing, which means young
women may get an abnormal smear result when there is nothing wrong. This
could lead to unnecessary treatment so screening young women might do more
harm than good.
Under the age of 25 years, invasive cancer is extremely rare, but changes in
the cervix are common. Although lesions treated in very young women may
prevent cancers from developing many years later, the evidence* suggests
that screening could start at age 25. Lesions that are destined to progress
will still be screen-detectable and those that would regress will no longer
be a source of anxiety. Younger women will not have to undergo unnecessary
investigations and treatments.
Gail
*P Sasieni, J Adams and J Cuzick, Benefits of cervical screening at
different ages: evidence from the UK audit of screening histories, British
Journal of Cancer, July 2003
