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 ab
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University of California - Davis - Health System