title: Report on a cryotherapy service for women with cervical intraepithelial neoplasia in a district hospital in western Kenya.
abstract: BACKGROUND
  In low-resource settings, cryotherapy can be cost-effective, affordable, and a first-line treatment for cervical intraepithelial neplasia (CIN) of any grade.
  
  
  OBJECTIVE
  To report the acceptability, safety and effectiveness of cryotherapy for women with cervical intraepithelial neoplasia (CIN) in Western Kenya.
  
  
  METHODS
  Visual inspection with acetic acid (VIA)-positive women and those suspected of having cervical cancer based on an initial evaluation at a primary health facility were referred to the district hospital for colposcopy and additional evaluation using visual inspection with Lugol's iodine (VILI) and/or visual inspection with acetic acid and magnification (VIAM). Cryotherapy was offered immediately to women diagnosed with appropriate CIN lesions based on colposcopy or after waiting for a confirmatory cervical biopsy and a follow up visit occurred one year later.
  
  
  RESULTS
  Ninety one 91 women 30 to 39 years of age had CIN appropriate for cryotherapy. Approximately 36% (24/67) were due for their 1 year follow up visit and 20 of 24 (83.3%) attended. Complete data were available for 18 of 20 (90%) and 13 (72.2%) had no sign of CIN. No serious adverse events were reported 1 to 3 months after cryotherapy. All respondents reported that the treatment experience was acceptable.
  
  
  CONCLUSIONS
  Cryotherapy was acceptable, safe and effective.
authors.affiliation: Reproductive Health Program, PATH, Seattle, USA. klewis@path.org
authors.forename: K D C
authors.initials: KD
authors.lastname: Lewis
authors.forename: J W
authors.initials: JW
authors.lastname: Sellors
authors.forename: A
authors.initials: A
authors.lastname: Dawa
authors.forename: V D
authors.initials: VD
authors.lastname: Tsu
authors.forename: N A
authors.initials: NA
authors.lastname: Kidula
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000601:surgery; D003452:Cryosurgery; D005260:Female; D006801:Humans; D007630:Kenya; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000601:surgery*