Hyatt Regency Phoenix | Phoenix, ArizonaPresented by: The American Society for Colposcopy and Cervical Pathology (ASCCP)

&Course Directors | Barbara S. Apgar, MD, MS | Beth C. Huff, MSN, NP

Excision Procedure

LoopElectrosurgical

(LEEP)March 22, 2013

Colposcopy: Case-Based Course

Advanced

March 23 – 24, 2013 Course Directors | L. Stewart Massad, MD | Lisa Flowers, MD

Announcing the 2012 Consensus Guidelines

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Loop Electrosurgical Excision Procedure (LEEP)Is this Educational Activity Right for Me?The ASCCP Loop Electrosurgical Excision Procedure (LEEP) course best serves those licensed physicians and advanced practice clinicians who are intermediate to advanced in their level of medical knowledge and colposcopic practice. It is expected that most participants are interested in learning LEEP in order to offer a wider range of treatment to the women in their communities. Participants will have either taken a basic colposcopy course or undergone a colposcopy rotation in residency and desire more in-depth learning about LEEP. After successfully completing the course, participants are expected to conduct hands-on mentored performance training as required for credentialing in new procedures by their home institutions, as the course will not prepare participants for independent practice. Participants will likely be those who have a sufficient patient volume to ensure that LEEP skills will be maintained.

Course Competencies and ObjectivesUpon completion of this educational activity, the pre-/post-test, course evaluation and short post-course survey, the learner should be able to:

•Medical Knowledge • apply the physics and electrosurgical principles of loop excision, especially

as they relate to equipment safety; • implement the criteria for appropriate triage of women to LEEP; • assess the equipment and supplies needed to perform LEEP; • recognize the potential complications—both immediate and delayed—and how

to manage them; • select the follow-up protocol for women after LEEP;

•Patient Care • perform loop excision on inanimate models with sufficient skill to perform procedures

under mentorship but not independently;•Practice-Based Learning and Improvement

• assess practice populations to identify adolescent, middle reproductive age, and postmenopausal women appropriate for LEEP treatment;

• adopt standardized guidelines on the treatment of women with cervical intraepithelial neoplasia;

• analyze practice experience to perform improvement activities;•Systems-based Practice

• demonstrate how practice systems differ, including resource allocation and controlling health care costs; and,

• advocate for quality patient care and assisting patients through system complexities.

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Course FormatLectures:The participants will attend general sessions consisting of didactic lectures covering the foundation of knowledge regarding the loop excision procedure. Each session will conclude with participant questions and faculty answers. There will be 4.75 hours of lecture and 45 minutes of faculty-led questions and answers.

Faculty Demonstration and Video Session:A faculty member will perform the procedure on a simulator to demonstrate technique and review principles learned in the other sessions. A short video detailing the essentials of LEEP is included.

Hands-on Learning Practicum:A non-CME session on the techniques of the loop procedure is provided under the direct supervision by faculty. Interactive exposure with experienced faculty will be offered so that each participant receives personal attention during a simulated procedure. This will allow participants to practice the skills discussed in the lectures including simple LEEP excision, top-hat excision, and infiltration of anesthesia. Participants will learn appropriate procedure documentation. Equipment and supplies for LEEP will be demonstrated.

Continuing Medical Education ACCME AccreditationThe American Society for Colposcopy and Cervical Pathology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

ASCCP — The American Society for Colposcopy and Cervical Pathology designates this live activity for a maximum of 5.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Instructions for Obtaining Continuing Medical Education Credit To complete this program successfully and receive credit and a certificate of attendance, participants must:

•Sign in at the ASCCP registration desk and attend all sessions;•Complete the pre- and post-tests found online at www.asccp.org;•Read the program objectives and program syllabus;•Read, complete and submit the program evaluation online following the post-test

(instructions will be in your course syllabus); and,•Complete the post-course assessment exercise (15-minute survey).

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Course FacultyBarbara S. Apgar, MD, MSCourse Co- DirectorProfessorDepartment of Family MedicineUniversity of Michigan Medical CenterAnn Arbor, Michigan

Beth C. Huff, MSN, NPCourse Co- DirectorAssistant Professor, retiredDepartment of Obstetrics and GynecologyVanderbilt University Medical CenterNashville, Tennessee

Mark H. Einstein, MDAlbert Einstein College of MedicineDivision of Gynecologic OncologyBronx, New York

Richard W. Lieberman, MDAssociate Professor Departments of Pathology and Obstetrics

and GynecologyUniversity of Michigan Medical SchoolAnn Arbor, Michigan

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Loop Electrosurgical Excision ProcedureMarch 22 , 2013 • Hyatt Regency Phoenix

Agenda6:30 am Registration/Breakfast7:00 am Welcome and Announcements7:15 am Review of ASCCP Consensus Guidelines7:45 am Comparison of Ablation, LEEP, Cold Knife Conization8:05 am Physics and Electrosurgical Principles8:25 am Equipment and Supplies9:15 am Participant Questions & Faculty Answers9:30 am Break9:45 am Selection of Patients for LEEP10:15 am Procedure Description11:00 am Postoperative Management11:30 am Lunch (on your own)12:30 pm Cases Using Consensus Guidelines (focus on + endocervical margin)1:00 pm Management of Surgical Specimens: The Pathologists Perspective1:20 pm Images of Post-LEEP Cervices1:30 pm Q & A2:00 pm Hands-on (45 minutes each, Non-CME sessions)

• Equipment and Supplies • Electrosurgical Generator • Dispursive Pad • Smoke Evacuator • Electrodes: Loop and Ball • Supplies: Insulated Materials

• LEEP: Preliminary Essentials • Technique of Injection of Anesthesia/ Supplies • Documentation/Informed Consent

• Procedure Practice with Inanimate Models • Simple Excision • Top-hat Excision

4:15 pm Adjourn/Course Evaluations

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Advanced Colposcopy: Case-Based CourseIs this Educational Activity Right for Me?The 2012 ASCCP Consensus Guidelines for Management of Women with Abnormal Cervical Cancer Screening Tests and CIN/AIS will be released March 21, 2013. The updates established broad concepts about secondary and tertiary prevention of cervical cancer. Generalizations, however, can be difficult to apply to specific clinical situations. This course provides clinicians with a working understanding of the rationale underlying the recommendations and offers an opportunity to use the updated guidelines to solve clinical problems resulting in improved patient outcomes.

The target audience is all intermediate level clinicians who interpret the results of cervical cancer screening tests and who diagnose, observe, and treat preinvasive disease (e.g., gynecologists, family physicians, advanced practice clinicians (to include NPs, CNMs, PA-Cs), gynecologic oncologists, and residents in obstetrics-gynecology and family medicine). Learners will have familiarity with the core natural history of human papillomaviruses and cervical intraepithelial neoplasia; the gross and colposcopic anatomy of the cervix, vagina, and vulva; and, the fundamental principles of management of lower genital tract diseases.

Course Competencies and ObjectivesThis course has been designed to improve clinician competencies and practice and thus improve patient care. Upon completion of this activity, learners will be able to:

•Use the 2012 ACS/ASCCP/ASCP guidelines (medical knowledge);•Apply the basic and clinical science underlying the 2012 ASCCP Consensus Guidelines

to the individualized management of abnormal screening tests and preinvasive histologic lesions (systems-based practice, practice-based learning, patient care);

•Manage women from special populations (e.g., adolescent, postmenopausal, and pregnant women) with abnormal screening results and CIN/AIS (systems-based practice, practice-based learning, patient care);

•Implement cost-effective management of CIN, vulvar intraepithelial neoplasia (VIN) / vaginal intraepithelial neoplasia (VaIN), and HPV testing and vaccination (practice-based learning, patient care); and,

•Manage women treated for lower genital tract disease to identify recurrent or persistent lesions (practice-based learning, patient care).

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Course Educational MethodsCase Sessions/Group Discussions:In daily, faculty-led small group discussions, learners will work through case-based modules that illustrate the application of guidelines in individual cases. These sessions will provide intense and interactive exposure to multiple patient cases and will allow the learners to practice both assessing their understanding of the guidelines and selecting the proper screening and management pathways for patients. The case study discussions will utilize an audience response system, allowing the attendees to practice what has been learned and to receive immediate faculty feedback.

In the “Participant Cases” session, participants will present their own difficult cervical or vulvovaginal patient histories and images before the faculty and their colleagues for assessment and discussion.

Open Question and Answer Sessions: There will be a daily open question and answer period led by the presenter(s). Questions are solicited from the audience, are read to the audience, and answers are addressed to the audience. In addition, educators seek teaching opportunities at breaks to answer specific questions one-on-one.

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Continuing Medical Education ACCME AccreditationThe American Society for Colposcopy and Cervical Pathology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The ASCCP Advanced Colposcopy course was planned and produced in accordance with the ACCME’s Essential Areas and Elements and Updated Criteria (see www.accme.org).

Continuing Medical Education CreditsASCCP — The American Society for Colposcopy and Cervical Pathology designates this live activity for a maximum of 10.25 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Instructions for Obtaining Continuing Medical Education Credit To complete this program successfully and receive credit and a certificate of attendance, participants must follow these steps:

•Sign in each day at the ASCCP registration desk and attend case study sessions and question and answer sessions;

•Read the educational objectives and review and utilize the course syllabus;•Complete the pre- and post-tests found online at www.asccp.org;•Complete the course evaluation form online immediately following the post-test; and,•Complete the post-course assessment exercise (15 minute survey).

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Course FacultyL. Stewart Massad, MDCourse Co-DirectorProfessorDivision of Gynecologic OncologyDepartment of Obstetrics and GynecologyWashington University School of MedicineSt. Louis, Missouri

Lisa Flowers, MDCourse Co-DirectorEmory University School of MedicineDivision of Gynecology & ObstetricsAtlanta, Georgia

Nancy R. Berman MSN, APRN-BCNurse Practitioner Millennium Medical Group, PCSouthfield, Michigan

David Chelmow, MDLeo J. Dunn Distinguished Professor and Chair

Department of Obstetrics and GynecologyVirginia Commonwealth University

Medical CenterRichmond, Virginia

Beth C. Huff, MSN, NPAssistant Professor (retired)Department of Obstetrics and GynecologyColposcopy Clinic CoordinatorVanderbilt University Medical CenterNashville, Tennessee

Edward J. Mayeaux, Jr., MDProfessor of Family MedicineProfessor of Obstetrics and GynecologyLouisiana State University Health

Sciences CenterShreveport, Louisiana

Peter F. Schnatz, DOAssociate Chair & Residency

Program DirectorThe Reading Hospital and Medical CenterReading, Pennsylvania

Terence J. Colgan, MDMount Sinai HospitalPathology & Laboratory MedicineToronto, Canada

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Advanced Colposcopy: Case-Based AgendaMarch 23 – 24, 2013 • Hyatt Regency Phoenix • Phoenix , Arizona

AgendaSaturday, March 236:30 – 7:45 am Breakfast/Registration7:45 – 8:15 am Welcome and Case-based Course Goals/Objective8:30 – 9:00 am Screening 19:00 – 9:30 am Screening 29:30 – 10:00 am Coffee/Tea Break10:00 – 10:30 am Negative Pap but HPV +10:30 – 11:00 am Atypical Squamous Cells of Undetermined Significance (ASC-US) 11:00 – 11:30 am Low-grade Squamous Intraepithelial Lesion (LSIL)11:30 am – 1:30 pm Lunch (on your own)1:30 – 2:00 pm Colposcopy negative or CIN1 after lesser abnormalities 2:00 – 2:30 pm Colposcopy negative or CIN1 after ASC-H/HSIL2:30 – 3:00 pm Coffee/Tea Break3:00 – 3:30 pm ASC-H/HSIL 3:30 – 4:00 pm Cervical Intraepithelial Neoplasia (CIN) 2,3

Sunday, March 246:30 – 7:45 am Breakfast/Registration7:45 – 8:00 am Announcements8:00 – 8:30 am Questions and Answers8:45 – 9:15 am HPV Testing9:15 – 9:45 am HPV Vaccination9:45 – 10:15 am Coffee/Tea Break 10:15 – 10:45 am Unsatisfactory and limited Pap tests 10:45 – 11:15 am Pregnancy11:15 – 11:45 am Young Women11:45 – 1:15 pm Lunch (provided by ASCCP)1:15 – 1:45 pm AGC/AIS1:45 – 2:15 pm Microinvasive Cancer 2:15 – 2:45 pm VIN2:45 – 3:15 pm Coffee/Tea Break3:15 – 3:45 pm Difficult Cases3:45 – 4:15 pm Participant Cases 4:15 pm Adjourn

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Management of Disclosure of Interest and Contributed FundsAs an accredited provider of CME credit, ASCCP is required to comply with the ACCME’s Standards of Commercial Support and has implemented a management process to ensure that anyone who is in a position to affect the content of the educational activity (e.g., faculty, planners, etc.) has disclosed to us all relevant financial relationships with any commercial interest and has ensured that those relationships do not influence presentation materials. All faculty have agreed to base their presentations on best available evidence. ASCCP discloses to learners any financial relationship(s) to healthcare-related commercial interests existing within the past 12 months to include the following information: 1) the name of the individual; 2) the name of the commercial interest; and, 3) the nature of the relationship the person has with each commercial interest. Course directors review presentation materials for possible bias prior to the course, and potential conflicts of interest are resolved prior to the presentation. Any discussion of off-label use of products is noted when appropriate, as is discussion of any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. Disclosures of these commitments and/or relationships are published in the course materials and provided from the podium so those participants in the activity may formulate their own judgments regarding the presentation(s). Course directors and co-directors also monitor presentations for bias and intervene as appropriate to provide balance. Under ASCCP policy, anyone declining either to disclose or amend material to eliminate potential bias identified by the course directors will be replaced.

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Hotel InformationHyatt Regency Phoenix122 North Second Street Phoenix, Arizona Reservations: 1-888-421-1442 or 602-252-1234

Group Rate: $179.00 Single/Double Occupancy

Cut-Off Date: February 28, 2013

The Hyatt Regency Phoenix is conveniently located just across the street from the Phoenix Convention Center and walking distance to surrounding attractions. Whether your travels are for work or play, you’ll find the guest services at our Hyatt Regency Phoenix to be positively outstanding. With a full-service business center, high-speed Internet access throughout the hotel, Hyatt FastBoard™ and PDA Check-in, you can easily remain productive during your visit.

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Transportation Discover the premier alternative to Phoenix Sky Harbor airport hotels. Hyatt Regency Phoenix offers deluxe amenities, world-class service and a downtown setting close to the convention center and city attractions. With several convenient transportation options at your disposal, you’ll have no problem getting to and from our Phoenix airport hotel.

AAA TransportationPhone number: 480-889-1640 Rates to/from Airport $18.00 each way for taxi (4 person max).

Super ShuttlePhone number: 602-244-9000 Rates to/from Airport $13.00 each way per passenger. Guests may proceed directly to the hotel pickup area outside the baggage claim. The Super Shuttle is available 24 hours a day, runs constantly, on demand.

Course Registration FormMarch 22-24, 2013 • Hyatt Regency • Phoenix, Arizona

Name: ________________________________________________________________________________ First M.I. Last Degree

Address: ______________________________________________________________________________

City: _________________________________________________________________________________

State: _______________________________________________ Zip Code: ________________________

Daytime Phone: _________________________________ Fax: ____________________________________

E-mail: ________________________________________________________________________________

Case-Based Course Registration Fee Early Bird Rate Regular On or Before Mar 1, 2013 After Mar 1, 2013o ASCCP Physician Member $795.00 $845.00o ASCCP Member Advanced Practice Clinician (e.g. NP, PA-C, CNM, etc.) $695.00 $745.00o Physician Non-Member $995.00 $1045.00o Advanced Practice Clinician Non-Member $895.00 $945.00o Resident/Fellow $595.00 $645.00

Total Registration Fee $_______ $_______

Loop Electrosurgical Excision Procedure Course Registration Feeo ASCCP Member $495.00 $545.00o Non-Member $695.00 $745.00

Total Registration Fee $_______ $_______

ASCCP Annual Members’ Business Meeting and Reception (members only) Join us and keep up with all of the new educational initiatives being planned, express your interest in committee membership, thank Dr. Alan Waxman for his service and greet the incoming leadership.

o YES, I will attend the ASCCP’s Annual Business Meeting and Reception on Friday, March 22, 2013

Your registration is not confirmed until you receive an email receipt.

Please indicate below any special assistance required during the meeting (i.e. accessible transportation, aids for hearing

or vision, etc.) _____________________________________________________________________________

_______________________________________________________________________________

Method of Paymento Check o Visa o MasterCard o American Express

Credit Card Number ___________________________________________ Expiration Date _______________

Credit Card Verification Code (3-digit code on back of credit card) ______________________________________

Name (as it appears on the card) _____________________________________________________________

Signature ______________________________________________________________________________

Cancellation PolicyWritten cancellation must be received on or before February 23, 2013. Any notice received on or before February 23, 2013 will be refunded, less a $100.00 administrative fee. No refunds will be made after February 23, 2013.

Send Completed Registration Form to:ASCCP•1530TilcoDrive•SuiteC•Frederick,Maryland21704

or fax this form to the ASCCP at (301) 733-5775

Sorry, telephone registrations cannot be accepted. All course seats are awarded on a first come, first served basis.

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