Navigation Links
Women with previous abnormal cervical cells at higher risk for recurrence and invasive cancer
Date:5/12/2009

New research from the UC Davis Center for Healthcare Policy and Research has found that women who have been treated for cervical intraepithelial neoplasia (abnormal cervical cell growth), are at higher risk for a recurrence of the disease or invasive cervical cancer. The large, population-based study, which appears in the May 12 online issue of the Journal of the National Cancer Institute, sheds new light on the long-term risks of subsequent abnormal cell growth or invasive cancer, and should help in the development of follow-up treatment guidelines for women with a history of treatment for abnormal cells.

"We now have a much more clear idea of the risks of recurrent abnormal cells and invasive cervical cancer over time after treatment of these cells," said Joy Melnikow, Professor of Family and Community Medicine and Associate Director of the UC Davis Center for Healthcare Policy and Research, who led the study. "Recurrence risk depends on the grade of abnormal cells that was initially treated, what treatment was used and the woman's age."

In the study, which used data from the British Columbia Cancer Agency cytology database and was funded by a grant from the National Cancer Institute, Melnikow and colleagues identified 37,142 women who were treated for abnormal cells from Jan. 1, 1986 through Dec. 31, 2000. They compared them with a group of 71,213 women with no previous diagnosis of abnormal cells. Both groups were under active surveillance through 2004.

They found that risk of subsequent abnormal cells or cervical cancer was associated with the type of treatment they received, their age and the initial grade of diagnosis. There are three levels of abnormal cervical cells; grade 3 is the most severe. There is no standard treatment for abnormal cells; at early stages, abnormal cells are monitored to determine if they resolve without treatment. At later stages, the type of treatment depends on several variables, including the grade and distribution of the abnormal cells and whether the patient has been treated previously.

According to the study, the risk of invasive cervical cancer and recurrence of grade 2 or grade 3 abnormal cells was highest for women who were older than 40, previously treated for grade 3, or treated with cryotherapy, a common treatment method in which the abnormal cells are frozen to stop their growth. Rates of recurrence at grades 2 and 3 were lowest among women treated with cone biopsy, a method in which the abnormal cells are removed surgically.

Melnikow said the findings could help guide physicians in making recommendations about the intensity of follow up needed after treatment for abnormal cells. In addition, she said the findings may help physicians and patients in deciding which type of treatment for abnormal cells to choose. She explained, for example, that while cryotherapy was associated in the study with a higher risk of recurrence, it carries less risk of other harmful effects than cone biopsy or loop electrical excision, procedures which have been associated with pre-term delivery in women who later become pregnant. This suggests that a younger woman with grade 2 abnormal cells who plans to start a family might opt for cryotherapy, while an older woman with grade 3 abnormal cells who is at greater risk for recurrence might opt for loop excision or cone biopsy.

"These data may help inform that treatment discussion, because we know more about how age and different treatments appear to influence risks," Melnikow said.

The study also found that the highest rates of recurrence of abnormal cells were observed in the first six years after treatment; the majority of those were identified in the first two years. Recurrence rates for grade 2 or grade 3 abnormal cells during the 6-year period ranged from 2.3 percent in the lowest risk group to 35 percent in the highest risk group. Overall incidence of cervical cancer in the abnormal cell group was 37 cervical cancers per 100,000 woman-years, compared with six cervical cancers per 100,000 woman-years among women not previously diagnosed.

Melnikow pointed out that the study also has different implications for health policy depending on the health system and resources. In developing countries where cervical cancer screening and treatment are more limited and death rates higher for cervical cancer, cryotherapy, a simpler and less expensive treatment method for abnormal cells, is likely to be preferred.

Melnikow said the next step is to compare different treatment and surveillance strategies in terms of cost-effectiveness.


'/>"/>

Contact: Dorsey Griffith
dorothy.griffith-pease@ucdmc.ucdavis.edu
916-734-9118
University of California - Davis - Health System
Source:Eurekalert

Related medicine news :

1. Antioxidants show no clear benefit against cardiovascular events, death in high-risk women
2. Work-Family Conflict Dogs Air Force Women After Deployment
3. Work-Family Conflict Dogs Air Force Women After Deployment
4. Antioxidant Supplements May Raise Womens Skin Cancer Risk
5. Early Weight Loss in Women Linked to Dementia
6. For Health Info, Women Often Turn to the Web
7. Smoking increases risks for head and neck cancers for men and women
8. New Study Reports High Injury Rates for Hotel Workers, Even Higher Rates for Women and Nonwhites
9. Passive smoking increases sleep disturbance among pregnant women
10. Trial to Test Gene Therapy for Angina in Women
11. Exercise and yoga improves quality of life in women with early-stage breast cancer
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... Apple ... care services, staged a mock evacuation of the facility as part of a disaster ... Fire Department, Echo Hose EMS and Shelton City Emergency Manager, as well as the ...
(Date:10/13/2017)... , ... October 13, 2017 , ... Global Healthcare Management’s ... Alexandria Park in Milford, NJ. This free event, sponsored by Global Healthcare Management’s ... The fun run is geared towards children of all ages; it is a ...
(Date:10/13/2017)... ... October 13, 2017 , ... “The Journey: From the ... danger possible to save lost souls in the Philippines. “The Journey: From the Mountains ... a dedicated teacher of the Bible. She has taught all ages and currently teaches ...
(Date:10/12/2017)... ... October 12, 2017 , ... Planet Fitness, one of the largest and ... plans to open a flagship location in Covington, LA at 401 N. U.S. Highway ... store next to Office Depot in the Holiday Square shopping center. Its location allows ...
(Date:10/12/2017)... ... 2017 , ... Asante, a nationally recognized health system in ... existing home health joint venture through an agreement, effective October 1, 2017, to ... home health company with Asante, delivering clinically integrated care, for the past eight ...
Breaking Medicine News(10 mins):
(Date:10/10/2017)... -- NDS received FDA 510(k) clearance in May 2017 for its highly ... designed for endoscopy environments. An innovative secondary monitor solution, ZeroWire ... support the improvement of patient outcomes, procedural efficiency, and the lowering ... ... ...
(Date:10/4/2017)... 4, 2017  South Korean-based healthcare product Development Company ... "cprCUBE" on Kickstarter. The device will educate the user ... with better efficiency compared to the dated and pricey ... on efficacy of the compression for a more informed ... goal to raise $5,000. ...
(Date:10/2/2017)... 2017  Eli Lilly and Company (NYSE: ... third quarter of 2017 on Tuesday, October 24, 2017. ... day with the investment community and media to further ... call will begin at 9 a.m. Eastern time. Investors, ... webcast of the conference call through a link that ...
Breaking Medicine Technology: