title: Meta-analysis of the effectiveness of cryotherapy in the treatment of cervical intraepithelial neoplasia.
abstract: BACKGROUND
  Cryotherapy can be used for the ablation of cervical intraepithelial neoplasia (CIN).
  
  
  OBJECTIVE
  To provide an updated and comprehensive estimate of the efficacy of cryotherapy for CIN.
  
  
  METHODS
  A literature search identified original studies (randomized controlled trials and clinical reports).
  
  
  METHODS
  Studies reporting cure rates, acceptability, and safety of cryotherapy were included in the analysis.
  
  
  METHODS
  Number of persistent or recurrent lesions at follow-up, adverse events, and complications were recorded. Quality of the methodology was also assessed. Meta-analyses were performed according to CIN thresholds, geographic region, study year, setting, study design, presence of endocervical involvement, freezing method, duration of follow-up, and status of the cryotherapy provider.
  
  
  RESULTS
  A total of 146 articles were retrieved; 77 papers--equivalent to 28,827 cases of treated CIN--were included in the meta-analysis. Cryotherapy achieved cure rates of 94.0% (CIN1), 92.0% (CIN2), and 85.0% (CIN3). Use of the double-freeze method and absence of endocervical involvement significantly increased cure rates. Minimal complications were reported as adverse effects.
  
  
  CONCLUSIONS
  Cryotherapy is an effective, safe, and acceptable treatment for CIN. It has been shown to be successful in low-resource settings, enabling availability and accessibility of early detection services.
authors.affiliation: Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France. sauvagetc@iarc.fr
authors.forename: Catherine
authors.initials: C
authors.lastname: Sauvaget
authors.forename: Richard
authors.initials: R
authors.lastname: Muwonge
authors.forename: Rengaswamy
authors.initials: R
authors.lastname: Sankaranarayanan
mesh_terms: D003452:Cryosurgery; D005260:Female; D006801:Humans; D016896:Treatment Outcome; D002578:Uterine Cervical Dysplasia / Q000601:surgery*