Tools for post LEEP surveillance.
Recurrences of cervical intraepithelial neoplasia (CIN) as well as invasive cervical carcinoma have been reported to arise following ablative or excisional treatment for cervical intraepithelial neoplasia. This review utilizes MEDLINE and National Library of Medicine's PubMed review of the various screening tools used in follow-up protocols for women treated by loop excision for CIN. Cervical cytology, colposcopy, endocervical curettage and HPV typing have been advocated for use as tools for follow up. Involvement of the surgical margins and the presence of HPV-DNA are associated with higher risks of recurrence and should be taken into consideration. The psychological impact of undergoing colposcopy may affect compliance with follow-up visits and should be dealt with appropriately.


OBJECTIVE
After completion of this article, the reader should be able to list the various tools that can be used for the surveillance of patients after treatment for CIN, to compare the advantages and disadvantages of each surveillance method, and summarize methods to improve compliance with follow-up.
Colposcopy unit, Department of Obstetrics and Gynecology, Western Galilee Hospital, Nahariya, Israel. mdjacob@tx.technion.ac.il
Jacob
J
Bornstein
Jacob
J
Schwartz
Alexander
A
Perri
Jefferey
J
Harroch
Doron
D
Zarfati
D002985:Clinical Protocols; D003127:Colposcopy; D004279:DNA, Viral / Q000032:analysis; D004598:Electrosurgery; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000517:prevention & control*; D030361:Papillomavirus Infections / Q000235:genetics; D010349:Patient Compliance; D011182:Postoperative Care; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*
D004279:DNA, Viral