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Screening for cervical cancer: guidelines are only guidelines, P.1

Cervical cancer, like other forms of cancer, is best treated when physicians are able to identify it early on and begin appropriate treatment as soon as possible. The presence of cervical cancer, according to the American Cancer Society, is typically first determined by a test called a colposcopy.

If something abnormal is seen in this test, a biopsy is then taken to determine the type of tissue at hand. If a biopsy shows that the tissue is pre-cancerous or cancerous, a patient is then given other testing to determine how much tissue is affected.

As many readers are aware, cancer screening comes with certain risks. In the case of colposcopies, the risks are relatively benign: usually just some discomfort. For biopsies and excisions, there can be pain and bleeding. For pregnant women, there is the risk of early birth or miscarriage. In addition, there can sometimes be false positive results, which can lead to unnecessary testing, which costs money, takes time and causes undue concern for patients.

In recent years, there has been increased awareness of the need to decrease unnecessary cervical cancer screening. "Better safe than sorry" doesn't necessarily translate into automatic testing. Under the most recent guidelines published by the American College of Physicians, women younger than the age of 21 are not recommended for screening. In addition, screenings are recommended to be performed not more than once every three years. Low risk women are not recommended for screening.

Following these guidelines is generally a safe bet for doctors from a liability standpoint, but there are always exceptions, and physicians can open themselves up to liability when they fail to order appropriate screening when the evidence is pointing to a need to do so.

We'll look more closely at this issue in our next post. 

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