Cold Coagulation of high grade premalignant disease of the cervix –
standing the test of time: a Retrospective study
Abstract
Analyse long term (20 years) cytology and histology outcomes following
treatment of high grade cervical intraepithelial neoplasia (HGCIN) with
Cold Coagulation (CC). Methods All women having CC for HGCIN
between Jan 1996 and December 1998 (36 months; n=885) were identified;
data was collected on age of patients, symptoms, colposcopy findings and
biopsy reports. Local and national (cytology and colposcopy) databases
and colposcopy records were used to collect long term follow up data.
Probability of CIN recurrence was assessed using Kaplan Meir ‘Survival’
curve. Results Follow up data (available for 796) was collected in
2018 capturing 20 years of follow-up data. 281 women were treated for
CIN2 and 515 women for CIN3. 791/796(>99%) were treated at
first visit and 152/796(19%) had symptoms at presentation.
262/796(33%) had evidence of glandular involvement on pre-treatment
biopsy. Probability of having consistently normal cytological follow up
was 92%, 89%, 86% and 83% at 5, 10, 15 and 20 years
respectively. Cumulative probability of having recurrent HGCIN was
0.5% at 5 years, 1% at 10years, 1.9% at 15 years and 3% at 18
years. Conclusion CC is a safe and effective treatment for HGCIN
which is now shown to have stood the test of time. We advise more
widespread adoption in the UK and globally so long as agreed criteria
are met.