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Is LEEP a feasible addition to the family physician's office?
G M Eilers1, T Swanson, J Kitowski
1Department of Family Medicine and Practice, University of Wisconsin.
Background:
Seven thousand women die annually from cervical cancer in the US. This disease is preventable if cervical dysplasia is treated. Loop Electrosurgical Excision of the Cervix (LEEP) is a new treatment for dysplasia. This study evaluates the acceptability and feasibility of having LEEP available in a family physician's office.
Method:
We performed a retrospective audit of colposcopy patients at 2 family practice clinics over a 2-year period. We determined the patients who met criteria for LEEP, surveyed the patients and calculated the cost benefit to the clinic.
Result:
Out of 288 patients undergoing colposcopy, 40 (14%) were candidates for LEEP. Few complications, minimal discomfort, and performance of the procedure at their primary clinic were important to patients. Patient cost for LEEP in the office is $700 compared to $1450 in the hospital. Nine LEEP procedures per year provides a break-even point for the clinic.
Conclusion:
LEEP offers the advantage over laser treatment of lower cost, use of local anesthesia, and provision of a pathology specimen. Performing LEEP in the family physician's office is cost effective and meets patient needs.