Cryotherapy for HPV clearance in women with biopsy-confirmed cervical low-grade squamous intraepithelial lesions.
OBJECTIVE
To compare the clearance rate of HPV infection among women aged older than 30 years with biopsy-confirmed cervical low-grade squamous intraepithelial lesions (LSIL) 1 year after cryotherapy with the spontaneous clearance rate (observation).


METHODS
HPV DNA typing by polymerase chain reaction and reverse line blot hybridization were used to identify 14 high-risk types and 23 low-risk types. HPV DNA sequencing was also used for other types.


RESULTS
Between December 2007 and March 2009, 100 women were recruited to the study and 60 cases had positive results on HPV testing. Twenty-nine patients were randomly allocated to the cryotherapy group and 31 to the observation group. At 1 year, 89.7% (26/29; 95% CI, 78.6-100%) of the cryotherapy group and 90.3% (28/31; 95% CI, 79.9-100%) of the observation group had negative results on HPV testing (0.6% difference; 95% CI, -15.8 to 14.6%, P=0.94).


CONCLUSIONS
Cryotherapy failed to increase the clearance of prevalent HPV infections among women with LSIL, although in both arms the clearance rates were above 80%. However, in coupling with visual inspection with acetic acid as a single visit approach, its effect on prevention of HSIL and cervical cancer is still promising. Therefore, cryotherapy should not be withdrawn from such programs.
Chumworathayi
Bandit
B
Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. bchumworathayi@gmail.com
Thinkhamrop
Jadsada
J
Blumenthal
Paul D
PD
Thinkhamrop
Bandit
B
Pientong
Chamsai
C
Ekalaksananan
Tipaya
T
D000328:Adult; D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology; D017679:Cryotherapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications / Q000628:therapy*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000628:therapy* / Q000821:virology