From diagnosis to treatment: a holistic approach to intraepithelial cervical disease

Sumedha Gupta; Dheer Singh Kalwaniya

doi:10.18203/2320-6012.ijrms20241937

Authors

Sumedha Gupta Department of Obstetrics and Gynaecology, VMMC and SJH, New Delhi, India
Dheer Singh Kalwaniya Department of Surgery, VMMC and SJH, New Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20241937

Keywords:

Intraepithelial cervical disease, Cervical dysplasia, Cervical screening, Excision techniques, Ablative techniques, Thermal ablation, VIA, Low resource settings

Abstract

Cervical cancer remains a significant cause of mortality among women worldwide. Screening methods play a crucial role in identifying individuals with cervical pre-cancerous lesions, allowing for timely intervention to prevent progression to invasive disease. Treatment modalities for cervical intraepithelial neoplasia (CIN) are effective, straightforward, and safe. The choice between ablative techniques (such as cryotherapy or thermal ablation) and excisional techniques (like large loop excision or cold knife conization) depends on lesion characteristics and transformation zone type. Ablative techniques are particularly suitable for low-resource settings due to their simplicity, low complication rates, and cost-effectiveness. In areas where access to colposcopy and histopathology services is limited, strategies such as visual inspection with acetic acid (VIA) followed by immediate ablative treatment for VIA-positive individuals are recommended by the World Health Organization. This approach not only prevents the progression of high-grade CIN but also ensures high compliance among screen-positive individuals. Overall, effective screening and treatment strategies are essential in reducing the burden of cervical preinvasive lesions and preventing the development of cervical cancer.

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