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Re: PAP Smear after TAHFrom: Zach Newton (zbnewton@atl.mindspring.com)Tue Dec 31 15:35:06 1996
The recent paper in the NEJM adds to expanding literature that provides the evidence-basis for deletion of routine Pap smear in the status-post- hysterectomy-for-benign-disease patient. Another recent paper with similar data and conclusions was published in the AJOG in 9/95 by Piscitelli. This conforms to the practice of ENT's, who do not perform routine Pap smears of the throat. The absence of an indication for Pap smear translating into the absence of an indication for annual gyn health maintenance encounter, as implied by Dr. Woolley, comes across as a non-sequitur. The issues central to the special focus of women's health care will more likely be revealed in a clinical setting dedicated to women's health care. The outcome data of mammography and Pap rates in gyn care vs general care are on record. The laundry list of special issues and appropriate assessment and management give justifiable cause to annual gyn evaluation by a qualified and interested health care provider, be it specialist, generalist or non-physician professional.
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