Interesting Study of the Week and Updates

Janelle, Excellent Ada County Jail nurse!

Set your TiVos!

For those interested in the Bath Salts phenomenon that I wrote about in “Bath Salts,” A Review and Bath Salts Update, CNBC is airing an hour-long program tonight about the “Bath Salts” and “Incense” phenomenon entitled Crime Inc.: A Deadly High.  The program promises to explore in detail this marketing phenomenon, as well as the designer drug analogue issue, in which chemists make minor changes to the chemical structure of an illicit chemical, thus making it legal.  Who knew that bath salts and incense generate an estimated  $5 billion per year!

Crime Inc.: A Deadly High airs tonight, August 2nd, at 8:00, 9:00 and midnight on CNBC.

Interesting Study of the Week

Moyer VA, for the U.S. Preventive Services Task Force. Screening for cervical cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med 2012;156:880-891.

This U.S. Preventative Services Task Force guideline replaces the one issued in 2003 and contains several important changes that will impact correctional facilities.

1.  Less than age 21.  No PAP smears before age 21.   No HPV (Human Papilloma Virus) screening.  Period.

2.  Age 21-30.  PAP smears every 3 years.  No HPV testing.

3.  Age 30-65.  PAP smears every 5 years.  HPV testing begins and is also done every five years.

4.  Age older than 65.  No PAP smears.

Implementing these official government guidelines will result in big changes in my facilities.  One of the facilities that I am the Medical Director for is the Idaho Juvenile Correctional Facility, which we call JCC and is the state juvenile prison.  Heretofore, we have done HPV testing and PAP smears on all of the girls entering the JCC.  According to these new guidelines, we should stop.  I need to discuss the matter with the medical administrator there (I’ll be calling, Mardi)!

The adult women in the state prison have been getting PAP smears as often as yearly and have come to expect them.  According to the new guidelines, we would only do them every 3 years from ages 21-30 and every five years thereafter until age 65.

On a personal note, a relative of mine (who prefers to not be identified) continues to dutifully report to her gynecologist for her annual “exam,” (including a PAP smear) even though she is well into her 80s.

The U.S. Preventative Services Task Force did not comment on the potential economic impact of this guideline, but it seems that it has the potential to save a lot of money in correctional facilities.  How much did your institution spend on PAP smears and HPV testing last year?  If you adopt these new guidelines, cut that in half.  At least.

Have you already implemented these guidelines at your facility?  How has it worked out?

Have you considered these new guidelines but have not implemented them?  Why not?

Please comment!

Essentials of Correctional Medicine is approved for CME credit!

Essentials of Correctional Medicine has been approved for 19.5 hours of Continuing Medical Education Credit by the American Academy of Family Physicians.  This conference should be a great learning experience as well as a good way to get Correctional Medicine specific CMEs!


2 thoughts on “Interesting Study of the Week and Updates

  1. What do you recommend for a 14 year old female who comes to the Juvenile facility and has already been diagnosed with HPV? With the new guidelines, should she wait and be retested at age 21 or would her circumstance require more frequent monitoring?

    • Well, Laura, the best reason not to order a test is that you do not care about the results. I assume that is why the task force says no HPV testing until age 30. So if we have gotten a positive HPV, then I guess we don’t care and ignore it until age 30.

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