Long term outcomes for women treated for cervical precancer

BMJ 2014; 348 doi: http://dx.doi.org/10.1136/bmj.f7700 (Published 14 January 2014)
Cite this as: BMJ 2014;348:f7700

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  1. M Arbyn, coordinator1,
  2. M Kyrgiou, MD2,
  3. J Gondry, professor3,
  4. K U Petry, professor4,
  5. E Paraskevaidis, professor5
  1. 1Unit of Cancer Epidemiology, Scientific Institute of Public Health, B1050 Brussels, Belgium
  2. 2West London Gynaecological Cancer Center, Queen Charlotte’s and Chelsea-Hammersmith Hospital, Imperial Healthcare NHS Trust, London, UK
  3. 3Department of Obstetrics and Gynaecology, University Hospital of Amiens, Amiens, France
  4. 4Department of Obstetrics and Gynaecology, Klinikum Wolfsburg, Wolfsburg, Germany
  5. 5Department of Obstetrics and Gynaecology, University Hospital of Ioannina, Ioannina, Greece
  1. marc.arbyn{at}wiv-isp.be

Cervical cancer risk increases with age and looks worse for women treated more recently. We need to find out why

Although the risk of cervical cancer after treatment for screen detected cervical precancer is low compared with non-treated women, the incidence of invasive cervical cancer is still significantly higher than in the general population.1 These findings are confirmed by Strander and colleagues (doi:10.1136/bmj.f7361) in a trend analysis that linked data from pathology, cancer, and cause of death registries that have covered the whole Swedish population for more than half a century.2 The authors report that the risk of developing or dying from cervical or vaginal cancer in women with a history of treatment for CIN3 (cervical intraepithelial neoplasia grade 3) is two to three times higher than in the general population. Furthermore the increase in risk among women treated for CIN3 rises significantly with older age and more recent year of treatment.

These results agree with previous data suggesting that the rates of residual or recurrent high grade CIN after treatment are higher for older than for younger women.3 4 Endocervical precancerous lesions, a predisposing factor for recurrence, are …

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