Be All-Inclusive When Advising On Cervical Ca


KAILUA KONA, HAWAII — Think of both ends of the fertility spectrum when advising women about preventing or treating cervical cancer, Kimberly D. Baker, J.D., said at a conference on obstetrics, gynecology, perinatal medicine, neonatology, and the law.

An increasing number of malpractice cases are being brought by teenagers who claim that no one adequately explained the risks of sexual activity and of avoiding Pap smears, said Ms. Baker, a defense lawyer in Seattle who also holds a bachelor's degree in nursing.

These adolescents lack an understanding of the threats that sexual activity and a lack of screening can pose to their bodies, their fertility, and even their lives if they contract a sexually transmitted disease. Physicians “are being too casual about this,” she said. “You need to document exactly what you said” in counseling the patient.

Explain things in terms that the teenager can understand, Ms. Baker said at the conference, which was sponsored by Boston University.

If a cervical lesion needs treatment, be sure to discuss the potential effects on fertility, especially when counseling young patients and older patients, she added. As more and more women delay childbearing, an increase in malpractice cases related to cervical cancer is being seen on the older end of the age spectrum when treatment fails to protect fertility, and the patient isn't warned of possible effects on fertility.

“Along with that, there needs to be a frank discussion about what is not available to them” if cervical cancer treatment affects fertility, she said.

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