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Dear Dr. Frascino
May 15, 2005

First of all, thank you very much for your precious time, your kindness and sense of humour. You must be a very special doctor. My question: "I had a pap smear test in NYC and it showed LOW GRADE LESIONS; and, since I didn't have much time in town -- I was coming back to Europe -- I decided to go ahead and "treat" those lesions. Do you think I made a mistake? I've heard (and read) that surgery may complicated things further, i.e. LOW GRADE LESIONS may turn into HIGH GRADE LESIONS. I'm so confused and scared that I-ve decided to write to you, since from all the doctors at The Body, you're one of the best. Thanks again for the great job. John

Response from Dr. Frascino

Hi,

Since your name is John, I'm assuming you had an anal pap smear, rather than the more common cervical Pap smear. I'm also assuming you are HIV positive, because this is an HIV information Web site. So with those assumptions, here's what I can tell you. Despite increasing information that HPV screening with anal pap smears in HIV Poz men is helpful in identifying both cancerous and pre-cancerous lesions, this type of testing has not yet become the standard of care in many HIV medical practices. In other words, lots of poz guys, particularly those who have never had anal warts or history of anal warts have never been screened with anal pap smears.

Do I think you made a mistake in getting screened and having your "low grade lesions" treated? No. Absolutely not. I don't know exactly what type of abnormal findings you had on your pap smear nor the type of treatment you underwent; however, I am not aware of any information that would indicate that treatment of low-grade lesions is harmful. That said, I do believe follow-up pap smears are indicated, because you had an abnormal smear in the past.

Bottom line on your bottom: I see no cause for additional worry due to your screening or treatment, but "butt" routine follow-up is warranted. OK?

Stay well.

Dr. Bob


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