Abstract
Purpose: Cervical cancer is still one of the main causes of cancer and mortality in women, especially in low- and middle-income countries, although it is a completely preventable disease through the detection and treatment of pre-cancer lesions. We evaluated the efficacy and tolerability of thermocoagulation treatment of high-grade cervical intraepithelial neoplasia (CIN 2 and 3). Methods: We evaluated 115 women with high-grade cervical intraepithelial neoplasia, 54 with CIN 2 and 61 with CIN 3, confirmed by biopsy and without previous treatment, from January 2016 to December 2018, undergoing thermocoagulation treatment at the Lower Genital Tract Pathology and Colposcopy Service of the Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil. Results: The mean age was 33.11 years (SD = 9.83) for CIN 2 and 35.28 years (SD = 7.97) for CIN 3 patients. Treatment efficacy was 90.8% in CIN 2 and 94.9% in CIN 3 cases. Pain was the main symptom reported at the time of treatment, occurring more frequently in the CIN 3 group (49.1% versus 27.8% in the CIN 2 group). As the more important long-term complication, there were 3 cases of pelvic inflammatory disease in CIN 2 (5.6%) and 3 in CIN 3 group (5.0%). The percentage of residual lesion was very low in both groups, 5 in CIN 2 group (9.2%) and 2 in CIN 3 group (3.4%). Conclusion: Thermocoagulation is an effective method for the treatment of cervical pre-cancer lesions (CIN 2 and CIN 3), with a low risk of adverse events and complications.
Highlights
Cervical cancer occurs mainly in less developed countries (85% of cases), being the fourth most common type of cancer among women worldwide
All women referred to the Lower Genital Tract Pathology and Colposcopy Service of the Hospital de Clinicasde Porto Alegre with a cervical intraepithelial neoplasia (CIN) 2/3 were submitted to an assessment of socio-demographic characteristics and a new analysis with colposcopy, cytology and biopsy and were divided in separate groups, those with CIN 2 and those with CIN 3
When we evaluated the CIN 3 group, in relation to factors associated with the presence of residual lesion 24 months after treatment, we observed that the chance was lower for women with more than one minimum wage and that the chance was higher for women with more than ten years of education and who had had more than one application of thermocoagulation, these results were not significant (Table S2)
Summary
Cervical cancer occurs mainly in less developed countries (85% of cases), being the fourth most common type of cancer among women worldwide It is still the second most common cause of death and cancer in the female population in low- and middle-income countries [1]. Mortality varies across different regions of the world, with rates ranging from less than 2 per 100,000 women in West Asia to 27.6/100,000 in East Africa [3]. This type of cancer is a completely preventable disease through the detection and treatment of pre-invasive lesions, cervical intraepithelial neoplasia (CIN) [4]. It is still a great challenge to carry out an organized screening and adequate treatment of all premalignant lesions diagnosed in the world [5]
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