Is LEEP a feasible addition to the family physician's office?
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Eilers
G M
GM
Department of Family Medicine and Practice, University of Wisconsin.
Swanson
T
T
Kitowski
J
J
Smith
M
M
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000295:instrumentation; D020681:Colposcopes; D003127:Colposcopy / Q000191:economics; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D004564:Electrocoagulation / Q000191:economics / Q000295:instrumentation*; D005194:Family Practice / Q000191:economics; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008485:Medical Audit; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000601:surgery*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000601:surgery; D014922:Wisconsin / Q000453:epidemiology