Cryotherapy of the uterine cervix: an inadequate treatment modality in a newly screened population.
A prospective trial of the efficacy of cryotherapy in cervical intra-epithelial neoplasia (CIN) was initiated at Baragwanath Hospital in Soweto, and incorporated 200 Black patients who had been evaluated by colposcopy and directed cervical biopsy before inclusion in the study. Only 52 patients (26%) achieved cytonegativity and adhered to the continuing follow-up schedule as advised (12 of these patients required repeat cryotherapy to achieve a cure). Another 39 patients (19,5%) were cytonegative when last seen, but did not fulfil the follow-up criteria required. Inclusive of this latter group, the cure rate achieved was 45,5% of the entire series, the average follow-up period being only 7,08 months. The results of the study demonstrated that cryotherapy cannot be regarded as the ideal form of management of CIN in a newly screened population, in whom the lesions detected are often extensive, with deep intraglandular involvement, and extension into the endocervical canal. For maximal therapeutic efficacy in any new cancer screening programme, it is advised that a policy of more liberal recourse to cold-knife conization be adopted, cryotherapy being reserved for patients with lesser degrees of CIN, in whom the lesion is confined to the surface epithelium of the ectocervix only
D000328:Adult; D002278:Carcinoma in Situ / Q000601:surgery*; D003452:Cryosurgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000601:surgery*