We try to publish authors’ responses in the same edition with readers’ comments. Time constraints might prevent this in some cases. The problem is compounded in a bimonthly journal where continuity of comment and redress are difficult to achieve. When the redress appears 2 months after the comment, 4 months will have passed since the article was published. Therefore, we would suggest to our readers that their correspondence about published papers be submitted as soon as possible after the article appears.
LEEP in the Family Practice Setting
To the Editor: I am writing to express my concerns about the conclusions in the article by Lyman and Morris about the use of the loop electrical excision procedure (LEEP) (Lyman DM, Morris B. LEEP in the Family Practice Setting. J Am Board Fam Pract 2003;16:204–8). The authors conducted a retrospective study of an underserved rural community in the management of cervical intraepithelial neoplasia (CIN) 2 and 3. They felt that their experience justified the use of LEEP. After reading the article, my concern is whether LEEP was medically necessary and whether it would have been more appropriate to offer cryotherapy for their patients. There is no substantive difference in outcomes between LEEP and cryotherapy regarding persistence and resolution in the treatment of squamous intraepithelial lesions for low-grade lesions, assuming a negative endocervical curettage.1 Cryotherapy can be provided at a lower cost and has fewer adverse complications than LEEP.