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Efficacy of thermoablation in treating cervical precancerous lesions in a low-resource setting
| Content Provider | Scilit |
|---|---|
| Author | Tran, Phuong Lien Kenfack, Bruno Foguem, Eveline Tincho Viviano, Manuela Temogne, Liliane Tebeu, Pierre-Marie Catarino, Rosa Benski, Anne-Caroline Vassilakos, Pierre Petignat, Patrick |
| Copyright Year | 2017 |
| Abstract | Efficacy of thermoablation in treating cervical precancerous lesions in a low-resource setting Phuong Lien Tran,1 Bruno Kenfack,2 Eveline Tincho Foguem,3 Manuela Viviano,1 Liliane Temogne,2 Pierre-Marie Tebeu,4 Rosa Catarino,1 Anne-Caroline Benski,1 Pierre Vassilakos,5 Patrick Petignat1 1Division of Gynecology, Department of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland; 2Department of Biomedical Sciences, University of Dschang, Dschang, Cameroon; 3Department of Gynecology and Obstetrics, District Hospital of Biyem-Assi, Yaoundé, Cameroon; 4Department of Gynecology and Obstetrics, University Centre Hospital, Yaoundé, Cameroon; 5Geneva Foundation for Medical Education and Research, Geneva, Switzerland Introduction: Treating cervical intraepithelial neoplasia (CIN) grades 2 and 3 is the recommended strategy for preventing invasive carcinoma in low- and middle-income countries (LMICs). Our objective was to assess the efficacy of thermoablation in the treatment of CIN2 and CIN3 in a screen-and-treat approach.Methods: Women aged 30–49 years in Dschang, Cameroon, were invited to undergo vaginal sampling for human papillomavirus (HPV), samples being assessed by an Xpert HPV Assay. HPV-positive women underwent visual inspection with acetic acid (VIA) and visual inspection with Lugol’s iodine (VILI), cervical biopsy, and endocervical curettage. Women positive for HPV-16/18/45 or other HPV types with abnormal VIA/VILI were treated by thermoablation on the same day. The primary outcome was persistence of high-grade disease on cytologic examination at 12 months.Results: Of a total of 1,012 recruited women, 188 were HPV-positive, 121 patients required thermoablation, and 99 had a CIN of grade <2, making the overtreatment rate 9.9%. The cure rate for CIN2 and CIN3 at 12 months was 70.6%. Failure (higher risk of persistent disease) was associated with the presence of occult endocervical lesions at baseline diagnosis (adjusted odds ratio [aOR] =128.97 [95% confidence interval [CI], 8.80–1,890.95]; p<0.0001). First sexual intercourse before the age of 15 was also a risk factor (aOR =0.003 [95% CI, 0.001–0.61]; p=0.023).Conclusion: In LMICs, use of thermoablation in a screen-and-treat approach is a valuable treatment option for CIN2 and CIN3. Studies comparing thermoablation with cryotherapy are needed to determine the most appropriate treatment for cervical precancer in such countries. Keywords: cervical cancer, HPV testing, self-sampling, thermoablation |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5716313/pdf https://www.dovepress.com/getfile.php?fileID=39533 |
| Ending Page | 886 |
| Page Count | 8 |
| Starting Page | 879 |
| ISSN | 11791411 |
| e-ISSN | 11791411 |
| DOI | 10.2147/ijwh.s142911 |
| Journal | International journal of women's health |
| Volume Number | 9 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2017-12-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: International Journal of Women's Health Obstetrics and Gynecology Hpv Testing Cervical Cancer Self-sampling Thermoablation |
| Content Type | Text |
| Resource Type | Article |
| Subject | Maternity and Midwifery Obstetrics and Gynecology Oncology |
