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Re: ASCUS/ Positive HPV in elderly From: Joanne Bulley, MD (islesannie@gmail.com) Thu Mar 27 20:53:44 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Joe: "Re: ASCUS/ Positive HPV in elderly" Previous message: ENDODOK@aol.com: "Re: ASCUS/ Positive HPV in elderly" In reply to: Kathleen Griffin, M.D.: "Re: ASCUS/ Positive HPV in elderly" Next in thread: ENDODOK@aol.com: "Re: ASCUS/ Positive HPV in elderly" The new "guidelines" that say "no paps" after age X ... end up with doubleing the number of cancers for those over age X - but it COSTS LESS to treat them with a late diagnosis of cancer than it would cost to screen them all. So you decide whether you accept the doubling the cancer risk. That is a place where the HRHPV screen can help. If Negative for HRHPV - and that will be 90-95% - then stop the PAPS - IF they have NO NEW sexual partner(s) (and I have plenty of 70 year olds with new sexual partners). But if they are HRHPV positive - they are still at risk. A related question is - does their HRHPB come out as preCA or cancer only when their immune system is down and out and they are at endstage disease of something else. If that is so - then that disease will "Get them first". I understand the public health side of this "if it costs $50,000 or less to screen to save one person - then we do the screen" otherwise, do not screen and some folks will get disease that could have been diagnosed earlier or prevented - but in the cost / benefit analysis - they don't get paps. It will be interesting to watch this discussion - as I know we have folks on opposite sides of this argument on this list. Joanne At Thu, 27 Mar 2008, Kathleen Griffin, M.D. wrote: > >I guess what I find ironic is the fact that per new guidelines, this 80 >year old shouldn't have had a Pap smear done at all, and now I am >obligated to colposcope her ad nauseum if she has persistent abnormal >Paps and persistent HPV, even though she is extremely unlikely to get >cervical cancer. > >-- >Kathleen Griffin, M.D. > -- Joanne Bulley, MD solo gyn Keene, NH "enjoying" the results of epidural depomedrol for a bulging L4-5 disc. Ruins the end of the ski season and start of hiking. Bah Humbug Next message: Joe: "Re: ASCUS/ Positive HPV in elderly" Previous message: ENDODOK@aol.com: "Re: ASCUS/ Positive HPV in elderly" In reply to: Kathleen Griffin, M.D.: "Re: ASCUS/ Positive HPV in elderly" Next in thread: ENDODOK@aol.com: "Re: ASCUS/ Positive HPV in elderly"

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