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

Precancerous changes in the cervix and risk of subsequent preterm birth.

Authors:

Bruinsma F , Lumley J , Tan J , Quinn M .

Mother and Child Health Research, Faculty of Health Sciences, La Trobe University, Carlton, Victoria, Australia. Objective The aims of this study were (i) to examine whether women referred for assessment of precancerous changes in the cervix had higher rates of preterm birth compared with those in the general population and (ii) to compare preterm birth rates for treated and untreated women adjusting for possible confounding factors. Design Retrospective cohort design. Setting Teaching hospital. Population All women referred to the Royal Women's Hospital, Melbourne (1982-2000), who subsequently had a birth recorded on the Victorian Perinatal Data Collection system (n= 5548). Methods Record linkage of hospital dysplasia clinic records and population-based birth records. Main outcome measures Total preterm delivery (<37 weeks of gestation) and subtypes. Results Both treated and untreated women were at a significantly increased risk for preterm birth compared with those in the general population treated-standardised prevalence ratio (SPR) 2.0, 95% CI 1.8-2.3 and untreated-SPR 1.5, 95% CI 1.4-1.7. Within the cohort, the treated women were significantly more likely to give birth preterm (adjusted OR 1.23, 95% CI 1.01-1.51). An increased risk of preterm birth was also associated with a history of induced or spontaneous abortions, illicit drug use during pregnancy or a major maternal medical condition. Cone biopsy, loop electrosurgical excision procedure and diathermy were associated with preterm birth. After adjusting for possible confounding factors, only diathermy remained significant (adjusted OR 1.72, 95% CI 1.36-2.17). Women treated using laser ablation were not at an increased risk for preterm birth (adjusted OR 1.1, 95% CI 0.8-1.4). Conclusions Diagnosis of precancerous changes in the cervix (regardless of the treatment) was associated with an increased risk of preterm birth. Consideration should be given to the preferential use of ablative treatments.

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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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

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