LEEP of Cervix


	UM Guidelines

Loop Electrosurgical Excision Procedure (LEEP) of Cervix (Women's Health)

Ambulatory Care (AC)

BCBST modification effective May 2, 2008*

Deleted from: Clinical Indications

Milliman Care Guidelines Clinical Indications were deleted.

Added to: Clinical Indications

Indicated when ALL of the following are present:

[Abnormal PAP smear followed by colposcopically directed cervical biopsies

Cervical tissue pathology revealing any level of cervical intraepithelial neoplasia (CIN) - either low-grade squamous intraepithelial lesion (LGSIL) or high-grade squamous intraepithelial lesion (HGSIL)]* (BCBST modification effective May 2, 2008*)

References

Mitchell, M. F., Tortolero-Luna, G., Cook, E., Whittaker, L., Rhodes-Morris, H., Silva, E. (1998). A randomized clinical trial of cryotherapy, laser vaporization, and loop electrosurgical excision for treatment of squamous intraepithelial lesions of the cervix. Obstetrics and Gynecology, 92(5), 737-44.

Nuovo, J., Melnikow, J., Willian, A. R. & Chan B. K. (2000). Treatment outcomes for squamous intraepithelial lesions. International Journal of Gynaecology and Obstetrics, 68 (1), 25-33.

Wright, T. C., Massad, S., Dunton, C. J., Spitzer, M., Wilkinson, E. J., Soloman, D., for the 2006 American Society for Colposcopy and Cervical Pathology - sponsored Consensus Conference. (2007). 2006 Consensus guidelines for the management of women with cervical intraepithelial neoplasia or adenocarcinoma in situ. American Journal of Obstetrics & Gynecology, 197 (4), 340-345. Retrieved January 17, 2008 from http://www.asccp.org/consensus/histological.shtml.

Wright, T. C., Massad, S., Dunton, C. J., Spitzer, M., Wilkinson, E. J., Soloman, D., for the 2006 American Society for Colposcopy and Cervical Pathology - sponsored Consensus Conference. (2007). 2006 consensus guidelines for the management of women with abnormal cervical cancer screening tests. American Journal of Obstetrics & Gynecology, 197 (4), 346-355. Retrieved January 17, 2008 from http://www.asccp.org/consensus/cytological.shtml.

* These guideline(s) have been revised from the Milliman USA Milliman Care Guidelines. The portions of the guideline(s) which have been revised are identified through the use of [insert: italic, boldface, underlined, etc. as appropriate] text, and Milliman USA has neither reviewed nor approved the modified material. Any statement to the contrary or association of the modified material with Milliman USA is strictly prohibited. This document has been classified as public information.

The above information only contains the modified portion of the Milliman Care Guideline. If you wish to view the complete Milliman Care Guideline, please contact Milliman USA.