What treatments are available for pre-malignant conditions of the cervix?

Gynaecology: Loop diathermy excision of the cervical transformation zone in the management of cervical intraepithelial neoplasia (1990-411).

Source:

Contemporary Reviews in Obstetrics and Gynaecology. Vol 2(1) (pp3-58), 1990.

Abstract:

The aetiology and natural history of cervical intraepithelial neoplasia (CIN) are imperfectly understood. The belief that invasive carcinoma of the cervix may ensue unless CIN is eradicated remains the principal reason for treatment. Although low grade lesions (CIN 1) may behave differently from high grade lesions, treatment encompasses all grades, and will continue to do so until more reliable information about prognosis is available. In addition, there is considerable pressure from the patients themselves for treatment as a result of anxiety resulting from the knowledge that they have an abnormal PAP test (cervical smear). Since the mid-1970s, and even more since the introduction of a national cervical screening programme, there has been a great increase in the number of women requiring diagnosis and treatment because of abnormal PAP test (cervical smear)s. This increased workload has resulted in an increased demand for personnel experienced in the assessment and management of abnormal PAP test (cervical smear)s, and for effective treatments that are cheap, rapid and associated with little morbidity. Many patients are young and nulliparous, so that the preservation of cervical function, particularly future fertility, is an important consideration. Clinicians treating CIN must evaluate outcome not only in terms of disease eradication but also considering the preservation of cervical structure and function. These ideas have radically influenced the management of CIN, reflected by the swing from radical surgical excision to more conservative therapies.

Please click on the required question.

• 1 What is the cervix?
• 2 What is a cervical polyp?
• 3 What is meant by cervical erosion (ectopy) and cervicitis?
• 4  What is the transformation zone?
• 5 What is a 'Paptest' (PAP test (cervical smear) test)
• 6  My PAP smear test (cervical smear) shows inflammation. Should I be worried?
• 7  What are cells and what is an abnormal (pre- malignant) cell?
• 8 My PAP smear test (cervical smear) shows abnormal cells. Does this mean that I have cancer?
• 9  What is meant by the terms pre-malignant cells, dyskaryosis, dysplasia and CIN?
• 10  What are the symptoms of pre-malignancy of the cervix?
• 11  What are benign and malignant tumours?
• 12  Why have I developed a pre-malignant condition of my cervix?
• 13  What is colposcopy?
• 14  What treatments are available for pre-malignant conditions of the cervix?
• 15  Can pre-malignant conditions of the cervix be cured?
• 16  How can I be re-assured that the pre-malignant changes will not recur?
• 17  How can we prevent carcinoma of the cervix?
• 18  Is there a reason to screen for HPV?
• 19  Support Groups.
• 20  Are there any support groups?

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