It has long been known that HPV (human papillomavirus) strains 16 and 18 cause the majority of cancers relating to this virus. Recent approval by the FDA of the Roche HPV test, which incorporates genotyping for these particular strains, will be helpful when it comes to monitoring patients who are at higher risk than others in developing persistent infections and subsequently cancer.
There are very well-developed guidelines by the Society for Colposcopy and Cervical Pathology to assist the practicing physician in the appropriate treatment of women with varying degrees of disease, in addition to post-treatment recommendations.
In a recent study published in the Journal of Lower Genital Tract Disease by Radha Malapati, M.D., et al, he studied factors that influence the persistence or recurrence of precancerous lesions, known as cervical intraepithelial neoplasia, after a LEEP procedure. LEEP, Loop Electrosurgical Excision Procedure, is one option for removing precancerous lesions, which are considered more serious in nature.
Surprisingly, 52 of the 769 patients selected for the study had to be excluded secondary to “ineligible entries, index cytology report not recorded or incorrect medical record numbers”. Since a preoperative cytology report would have been necessary for treatment in the first place, the fact that cytology reports were missing is an omission and lack of thoroughness on the part of the treating physician.
The ASCCP (American Society for Colposcopy and Cervical Pathology) previously conducted a survey, which showed a significantly large percentage of the practicing medical community failed to understand the current guidelines. It would appear that not only is there a lack of knowledge on the part of the physicians, but a lack of adequate record keeping as well.
Review of the “conclusions” for Dr. Malapati’s study is even more direct when it comes to following the established guidelines regarding follow-up after treatment with LEEP.
Of the 717 remaining patients, the rate of follow-up was a mere 64.7 percent.