Recently, I have had a run of several young women who have presented (accompanied by their mothers) having received a diagnosis elsewhere of polycystic ovarian syndrome (PCOS). They have looked this up online and they are relatively distraught having learned about issues of infertility, insulin resistance, and a predilection later in life for diabetes. None of these recent cases truly had the entity itself. What they had was not unusual for late adolescence (women in their teens and even early t...
To my patients, In last week’s Science Times, the weekly column on personal health by Jane Brody was entitled, “A New Focus Turns to Preventing Breast Cancer.” I have tremendous respect for Jane Brody and almost always agree with what she writes and the thoroughness with which she presents information. There are, however, some points in that article that I feel I must comment on. She does mention, and rightly so, that if breast cancer is confined to the breast with no spread ...
“If it ain’t broke why are we fixing it?” This week the United States Preventative Services Task Force (USPSTF) published a recommendation statement in the Journal of the American Medical Association (JAMA) They made updated recommendations for screening for cervical cancer using Pap smears (which they call cervical cytology) and high risk HPV testing or both in combination. I have some real problems with these kinds of recommendations. Their goals are to prevent cervical cancer and re...
2/12/2014 In today’s New York Times on the front page there is an article about a long-term Canadian study involving mammographic screening for breast cancer. It looked at over 90,000 women randomized to get mammographic screening vs. those who only had a breast exam by a nurse without mammography. It lasted 25 years. It was published in the British Medical Journal. It found that there was no difference in deaths from breast cancer in either group (about 1 death per 90 women enrolled over the...
05/01/2013 An article appeared in yesterday's NY Times Science section about the lack of benefit and even potential harm of the routine bimanual pelvic examination in gynecology. It is so inaccurate and one sided that I have sent a letter to the Times which I have reproduced for you. (I am not optimistic that they will choose to run it.) This is such important information you may want to share it with friends, colleagues and family... All reporters and most readers appreciate there are two s...
There was an article in the New York Times by Tara Parker-Pope entitled “The annual appointment loses some relevance”. It was about the highly publicized, but not so very different, pap smear guidelines by the USPSTF (United States Preventative Services Task Force). The guidelines had already been changed several years ago making the recommendation for less screening in some women. At that time, as a member of the Editorial Board of Contemporary ObGyn, I wrote a piece entitled “If it...
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