Clinical Review
UPDATE ON CERVICAL DISEASE
Guidelines have changed again, of necessity. Here is a roundup of the major alterations and new guidance.
When the American Board of Obstetrics and Gynecology (ABOG) announced in September that, with a few exceptions, gynecologists could lose their board certification if they treated men, gynecologists were forced to stop treating male patients. This decision has now been altered, and gynecologists are now allowed to treat male patients for sexually transmitted diseases (STDs) and to screen men for anal cancer.1
Experts in anal cancer and patient advocacy groups lobbied ABOG to revise their position based on gynecologists’ long-standing tradition of treating men and women for STDs. Anal cancer is usually caused by human papillomavirus. Although rare, the incidence of anal cancer is increasing, especially among those infected with human immunodeficiency virus.1
ABOG’s new statement reads2:
To remain certified by ABOG the care of male patients is prohibited except in the
following circumstances:
- active government service
- evaluation of fertility
- genetic counseling and testing of a couple
- evaluation and management of sexually transmitted infections
- administration of immunizations
- management of transgender conditions
- emergency, pandemic, humanitarian or disaster response care
- family planning services, not to include vasectomy
- newborn circumcision
- completion of ACGME-accredited training and certification in other specialties.
Mark H. Einstein, MD, professor in the Department of Obstetrics and Gynecology and Women’s Health at Montefiore Medical Center in Bronx, New York, and author of “Update on Cervical Disease” (OBG Management, May 2013), was forced to discontinue seeing male patients. He commented, “Cool heads have prevailed. This is the best decision for our patients.”1
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