Effectiveness of cryotherapy for histologically confirmed cervical intraepithelial neoplasia grades 1 and 2 in an Indian setting

Int J Gynaecol Obstet. 2013 Oct;123(1):16-20. doi: 10.1016/j.ijgo.2013.06.009. Epub 2013 Jul 17.

Abstract

Objective: To describe the effectiveness of cryotherapy for treating women who were histologically confirmed to have cervical intraepithelial neoplasia (CIN) in India.

Methods: Data were analyzed retrospectively from screening projects that collected data from January 2001 to May 2008 in Trivandrum, India. Women with CIN were appropriately treated with cryotherapy by a trained nurse or physician and followed up for cure, adverse events, and complications. Cure was defined as absence of CIN during any follow-up visit at least 1 year after treatment.

Results: Among 236 women identified with CIN and appropriately treated with cryotherapy, 173 (81.6%) were followed up (158 CIN 1 and 15 CIN 2 cases). The percentage cure for CIN 1 and 2 lesions was 93.0% and 86.7% respectively. An odds ratio of 0.2 (95% confidence interval, 0.0-0.9) was observed for treatment received more than 2 months after screening as compared with treatment received within 2 months. Complications were observed in 1.2% of treated women and adverse events (discharge and mild pain) in 26.6%.

Conclusion: The study affirms that trained mid-level providers can appropriately perform cryotherapy in primary healthcare services and that expanding such services in low-resource settings would increase the availability and accessibility of precancer treatment.

Keywords: Cervical cancer; Effectiveness; India; Precancerous lesions; Treatment.

MeSH terms

  • Adult
  • Cryotherapy / adverse effects
  • Cryotherapy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • India
  • Primary Health Care / methods*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Dysplasia / therapy*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / therapy*