Efficacy, acceptability and safety of ablative versus excisional procedure in the treatment of histologically confirmed CIN2/3: a systematic review

In a new systematic review, scientists from the International Agency for Research on Cancer (IARC) compared the efficacy, acceptability, and safety of ablative and excisional procedures to treat histologically confirmed cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3) lesions. The results were published in BJOG: An International Journal of Obstetrics & Gynaecology.

This systematic review included four randomized controlled trials in which the trial authors clearly stated that the CIN2/3 lesions were suitable for either ablative or excisional procedures. The two treatment types were equally safe and acceptable. However, more evidence was needed to compare the efficacy of the two treatment types, especially according to HIV status and duration of follow-up.

In low- and middle-income countries where the incidence of cervical cancer is high, the management of cervical precancerous lesions is a key factor in achieving elimination of cervical cancer. Demonstrating that ablative treatment, such as thermal ablation, is as efficacious as large loop excision of the transformation zone (LLETZ) in the treatment of high-grade lesions would enable many patients in resource-constrained settings with limited access to excisional treatment to benefit from simple, safe, acceptable, and feasible technologies such as thermal ablation.

Zhang L, Sauvaget C, Mosquera I, Basu P.
Efficacy, acceptability and safety of ablative versus excisional procedure in the treatment of histologically confirmed CIN2/3: a systematic review
BJOG, Published online 11 June 2022;
https://doi.org/10.1111/1471-0528.17251

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