title: The use and success of cold coagulation for the treatment of high grade squamous cervical intra-epithelial neoplasia: a retrospective review.
abstract: OBJECTIVE
  Cold coagulation is recognised as a viable, cost-effective and successful treatment for cervical intraepithelial neoplasia (CIN), being used less frequently than excisional treatments for high grade lesions. We set out to demonstrate successful long term follow-up of patient with high grade CIN treated with cold coagulation.
  
  
  METHODS
  We conducted a retrospective review over a one-year period of women with biopsy-proven CIN 2 and 3 who were treated with cold coagulation to the cervix, attending the colposcopy service of a large tertiary referral hospital. We examined follow-up cervical smear data for three years post treatment of low and high grade CIN, evaluated the success of treatment and re-treatment rates.
  
  
  RESULTS
  93 patients were included in our study, with 39 (41.9%) having CIN 1 and 54 (58.1%) diagnosed with CIN 2 or 3. Follow-up smears revealed low levels of recurrent high grade changes in both groups, with 31 (79.5%) of our CIN 1 group having a negative smear one year following treatment with cold coagulation, compared to 44 (81.1%) of patients with CIN 2 and 3. Successful primary treatment (i.e. no requirement for further treatment after 3 year follow-up) occurred in 33 (84.6%) of the CIN 1 group, and 42 (77.7%) of the CIN 2/3 group, demonstrating no statistical significance between re-treatment rates between both groups.
  
  
  CONCLUSIONS
  This study demonstrates the effectiveness of cold coagulation for the treatment of high grade cervical intraepithelial neoplasia. High success rates, and low re-treatment rates confirm that this is an acceptable primary treatment for CIN 2 and 3.
authors.affiliation: Department of Gynaecology, University Hospital Limerick, Limerick, Ireland. Electronic address: claire_mccarthy@hotmail.com.
authors.forename: C M
authors.initials: CM
authors.lastname: McCarthy
authors.affiliation: Department of Gynaecology, University Hospital Limerick, Limerick, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Ramphul
authors.affiliation: Department of Gynaecology, University Hospital Limerick, Limerick, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Madden
authors.affiliation: Department of Gynaecology, University Hospital Limerick, Limerick, Ireland.
authors.forename: K
authors.initials: K
authors.lastname: Hickey
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000473:pathology*; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*
keywords: Cervical carcinoma; Cervical intra-epithelial neoplasia; Cold coagulation; Gynae-oncology; Screening