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Cited by 88Cervical Cancer and HPV ResearchWomen's cancer prevention and managementEndometrial and Cervical Cancer Treatments

Worthy of further consideration: An updated meta-analysis to address the feasibility, acceptability, safety and efficacy of thermal ablation in the treatment of cervical cancer precursor lesions

Randall, Thomas C., Sauvaget, Catherine, Muwonge, Richard, Trimble, Edward L., Jeronimo, Jose·2019·Preventive Medicine
DOI 10.1016/j.ypmed.2018.10.006
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Abstract

Treatment of preinvasive lesions is critical to the success of secondary prevention of cervical cancer. In many settings, however, excision or ablation of preinvasive lesions can prove challenging. Thermal ablation (TA) is a form of treatment for cervical precancer that may present fewer logistical challenges in resource limited settings. In 2013, Dolman and colleagues wrote a meta-analysis of publications reporting cure rates from TA. This included only one article from a low or middle-income country (LMIC). We updated Dolman's meta-analysis to include more recent articles from LMICs. A formal review of the world literature was performed for the years 2014-2017. Article titles and abstracts were reviewed for relevance; full articles were assessed for quality. The primary endpoint was treatment outcome for cervical intraepithelial neoplasia grade 2 or higher (CIN2+). The I2 statistic was used to assess heterogeneity between studies. Studies were stratified by geographic region, decade that the study was published, World Bank economic classification of the country where the study was performed, and other factors. We reviewed 34 total reports and included 23 in our meta-analysis, including 10,995 and 6371 patients, respectively. A total of 7 studies were performed in LMICs, including 6 studies included in the meta-analysis. The overall response rate for TA treatment of biopsy proven CIN2+ was 93.8%. Consistent with the wide variety of settings and patient populations, there was significant heterogeneity between studies. TA appears to be an effective treatment for CIN2+ across a variety of settings, including in LMICs.

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Research works printed but not linked: 5

  1. Aref-Adib, 2013, Patient selection for cold coagulation, BJOG, 120, 45
  2. Cassidy, 1987, Cold coagulation revisited, Colposc. Gynecol. Laser Surg., 3
  3. Farquharson, 1987, The patient acceptability of laser and cold coagulation therapy to the cervix for treatment of cervical intra-epithelial neoplasia (CIN) 2-3, Colposc. Gynecol. Laser Surg., 3
  4. Hirae, 2015, Three year follow up of cervical intraepithelial neoplasia 2, BJOG, 122, 137
  5. Smart, 1987, Randomised trial to compare laser with cold coagulation therapy in the treatment of CIN II and III, Colposc. Gynecol. Laser Surg., 3, 48

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Authors
Randall, T. C., Sauvaget, C., Muwonge, R., Trimble, E. L., & Jeronimo, J.
Affiliations
  • Harvard University (US)
  • Centre international de recherche sur le cancer (FR)
  • National Cancer Institute (US)
Corresponding author
Randall, Thomas C.
ORCID
Venue
Preventive Medicine
Publisher
Elsevier BV
Published
2019-01
Volume
118
Pages
81-91
ISSN
0091-7435 (ISSN-L)
DOI
10.1016/j.ypmed.2018.10.006
OpenAlex
W2897238301
Cited by
88
References
47
Citations by year
2026: 7 · 2025: 13 · 2024: 7 · 2023: 15 · 2022: 14 · 2021: 10 · 2020: 15 · 2019: 6 · 2018: 1
FWCI
5.46
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Preventive Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
World Health Organization
Topics
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
  • Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
Keywords
thermal ablation, cervical precancerous lesions, cervical intraepithelial neoplasia, CIN2+, low- and middle-income countries, treatment efficacy, cure rate, resource-limited settings
MeSH terms
Radiofrequency Ablation, Uterine Cervical Dysplasia, Uterine Cervical Neoplasms, Feasibility Studies, Female, Humans, Treatment Outcome

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