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Growth of abnormal cells on the surface of the cervix. Numbers from 1 to 3 may be used to describe how abnormal the cells are and how much of the cervical tissue is involved.

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Surgery for pre‐cancerous cervix lesions (cervical intraepithelial neoplasia) often causes significant bleeding during surgery or within 14 days. This review found that good surgical technique can reduce immediate blood loss and bleeding can also be reduced by some drugs. Vasopressin reduces blood flow by constricting blood vessels. Tranexamic acid reduces blood loss after knife and laser cone biopsy. Stitches also reduce blood loss but can interfere with later visual examination of the cervix.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: December 4, 2013

Treatment for CIN is usually undertaken in an outpatient colposcopy clinic to remove the pre‐cancerous cells from the cervix (lower part of the womb). It commonly involves lifting the cells off the cervix with electrically heated wire (diathermy) or laser, or destroying the abnormal cells with freezing methods (cryotherapy). This is potentially a painful procedure.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 18, 2016

Cervical cancer is preceded by cervical intra‐epithelial neoplasia (CIN). Surgery for CIN is effective in reducing the risk of subsequent invasive carcinoma. An effective chemo‐preventive agent might avoid the need for surgery and reduce the cost and morbidity of work‐up and treatment. Retinoids are natural and synthetic derivatives of naturally occurring vitamin A. Overall, the retinoids studied are not effective in causing regression of severe CIN3 but may have activity in moderate CIN2. Data are inadequate to allow assessment of whether the retinoids studied are effective in preventing progression of any grade of CIN.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: June 6, 2013

Preterm birth risk is higher after local treatment for precancer of the neck of the womb (cervix), yet there are only a few research studies that have investigated the effect on fertility and early pregnancy outcomes following treatment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 29, 2015

This review is an update of a previously published review in The Cochrane Database of Systematic Reviews 2014, Issue 4 on non‐steroidal anti‐inflammatory agents (NSAIDs) to induce regression and prevent the progression of cervical intraepithelial neoplasia (CIN). Cervical intraepithelial neoplasia (CIN) is a common pre‐cancerous condition of the cervix associated with HPV (the human papillomavirus), which can occur in anyone but is commonly found in younger women who wish to maintain their fertility and treatment often involves surgical excision. CIN can progress to invasive cancer of the cervix. CIN is identified by screening and can be treated with surgery to the cervix either by removal with surgical excision or destruction of the cells covering the cervix such as with laser therapy, heating, or freezing. While this is effective in the majority of cases, the surgery can cause immediate unwanted effects, such as bleeding and infection, or later complications including difficulty with menses due to scarring of the cervix and early (premature) labour.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2018

Pre‐cancerous cervical lesions can be treated by either excision or destruction of the abnormal cells from the cervix, to reduce the risk of developing cervical cancer in the future. The advantage of excisional treatment is that the abnormal cells are removed, rather than destroyed, so tissue can be sent for detailed examination to confirm the diagnosis histologically and make sure the affected area has been completely removed. As the excision of the transformation zone leaves a raw area on the cervix, there is a risk of getting an infection following the procedure. Antibiotics are sometimes given before surgical procedures to prevent infection developing (prophylactic), rather than to treat an existing infection. However, prophylactic antibiotics may not be necessary or effective. In addition, antibiotics can cause side effects (adverse events). Importantly, there are increasing concerns about antibiotic over‐use promoting antibiotic resistance in bacteria.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 21, 2017

Background: Atypical squamous cells of undetermined significance (ASCUS) and low‐grade squamous intra‐epithelial lesions (LSIL) are minor lesions of the cervical epithelium, detectable by cytological examination of cells collected from the surface of the cervix of a woman.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 28, 2013

Cervical screening programmes reduce the risk of cervical cancer, through the use of cervical cytology (smear tests), which aim to detect and treat any precancerous changes which might put some women at risk of developing invasive disease (invasive cervical cancer) in the future. Usually only severe precancerous changes require treatment, however, there is some discrepancy in how to manage women with minor cytological changes (atypical squamous cells of undetermined significance (ASCUS/borderline) or low‐grade squamous intra‐epithelial lesions (LSIL/mild dyskaryosis) if HPV (human papillomavirus) testing is not routinely available.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 26, 2017

Persistent infection with some types of human papillomavirus (HPV) can cause anal canal intraepithelial neoplasia (AIN), a condition which may become cancerous. HPV is transmitted via skin‐to‐skin contact. There are over 100 different types of HPV virus. At least 30 of these can be sexually transmitted. HPV transmission occurs easily among sexual partners. Despite this, spontaneous clearance of the infection is generally the rule.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: December 12, 2012

BACKGROUND: A number of studies have explored the association between methyl enetetrahydrofolate reductase (MTHFR) C677T polymorphism and susceptibility to cervical cancer and cervical intraepithelial neoplasia (CIN). However, results remained controversial. To address this gap, we decided to conduct a meta-analysis of all available published studies.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

OBJECTIVE: In this review, we evaluate the diagnostic efficacy of optical spectroscopy technologies (fluorescence and reflectance spectroscopy) for the in vivo diagnosis of cervical neoplasia using both point probe and multispectral imaging approaches.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

BACKGROUND: Cryotherapy can be used for the ablation of cervical intraepithelial neoplasia (CIN).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

CONTEXT AND OBJECTIVE: The age-stratified performance of the oncogenic HPV-DNA (human papillomavirus deoxyribonucleic acid) test for triage of low-grade squamous intraepithelial lesions (LSIL) requires investigation. The objective of this study was to evaluate and compare the age-stratified performance (cutoff point: 35 years) of oncogenic HPV-DNA testing and repeated cytological tests, for detecting cervical intraepithelial neoplasia grade 3 (CIN3), in order to triage for LSIL.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Numerous case-control studies on the association between polymorphisms of key genes involved in methionine remethylation [methylenetetrahydrofolate reductase (MTHFR) and methionine synthase (MS)] and the susceptibility of cervical intraepithelial neoplasia (CIN) and cervical cancer have provided inconclusive results. The aim of the present meta-analysis was to determine the effects of two MTHFR (C677T and A1298C) and one MS gene polymorphism (A2756G) on the risk of CIN II/III or cervical cancer. Relevant data were retrieved following a systematic search in PubMed, Web of Science, MEDLINE and Wanfang Data up to November 2012. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated from eligible studies by meta-analysis with subgroup analyses stratified by ethnicity. A total of 13 studies with 1,936 cases and 2,858 controls were included in the present meta‑analysis. An increased risk of cervical cancer was found in Asian women with the MTHFR 677T allele (TT vs. CC: OR=1.41, 95% CI=1.07‑1.86, P=0.01; TT vs. CC+CT: OR=1.38, 95% CI=1.08-1.75, P=0.008), while a decreased risk was observed in Caucasian women (TT vs. CC: OR=0.65, 95% CI=0.45-0.93, P=0.02; TT+CT vs. CC: OR=0.7, 95% CI=0.58-0.86, P=0.0005). No effects of MTHFR C677T polymorphism on CIN II/III risk and MTHFR A1298C or MS A2756G polymorphisms on cervical cancer risk were detected. The sensitivity analysis suggested stability of this meta-analysis and no publication bias was detected. The MTHFR 677T allele may enhance the risk of cervical cancer in the Asian female population and play a protective role in Caucasian females. However, limited association is suggested between MTHFR A1298C and MS A2756G polymorphisms with cervical tumorigenesis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

OBJECTIVE: To evaluate the performance of visual inspection with acetic acid (VIA) in preliminary screening of cervical cancer and its precancerous lesions among Chinese women by meta-analysis of diagnosis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

OBJECTIVE: Perform a systematic review to determine the test performance of HPV mRNA testing compared to DNA testing using CIN2+ as the target condition.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

BACKGROUND: Human papillomavirus (HPV) DNA testing combined with cytology has been recommended as a primary cervical cancer screening strategy.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

OBJECTIVE: Bacterial vaginosis (BV), the most common vaginal disorder among women of reproductive age, has been suggested as co-factor in the development of cervical cancer. Previous studies examining the relationship between BV and cervical intra-epithelial neoplasia (CIN) provided inconsistent and conflicting results. The aim of this study is to clarify the association between these two conditions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

BACKGROUND: Over 60,000 women are treated for cervical intraepithelial neoplasia (CIN) each year in England, most by excision. Management of women who have incomplete excision is controversial and the subject of much debate. Consequently, the completeness of excision is often ignored in the planning of subsequent treatment. We aimed to assess the effect of completeness of excision on the risk of post-treatment disease.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Cervical pre‐cancer (cervical intraepithelial neoplasia) can be treated in different ways depending on the extent and nature of the disease. Less invasive treatments that do not require a hospital stay may be used. A general anaesthetic is occasionally needed, especially if the disease has spread locally, early invasion is suspected or previous out‐patient treatment has failed. Surgery can be done with a knife, cryotherapy (freezing the abnormal cells), laser or cutting with a loop (an electrically charged wire). This review found there was not enough evidence to confidently select the most effective technique and that more research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: December 4, 2013

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