• Marlieke de Fouw, Roos Marieke Oosting, Amy Rutgrink, Olaf Matthijs Dekkers, Alexander Arnold Willem Peters, and Jogchum Jan Beltman.
• Department of Gynecology and Obstetrics, Leiden University Medical Center, Leiden, Netherlands.
• Int J Gynaecol Obstet. 2019 Oct 1; 147 (1): 4-18.

BackgroundThermal coagulation is gaining popularity for treating cervical intraepithelial neoplasia (CIN) in screening programs in low- and middle-income countries (LMICs) due to unavailability of cryotherapy.ObjectivesAssess the effectiveness of thermal coagulation for treatment of CIN lesions compared with cryotherapy, with a focus on LMICs.Search StrategyPapers were identified from previous reviews and electronic literature search in February 2018 with publication date after 2010.Selection CriteriaPublications with original data evaluating cryotherapy or thermal coagulation with proportion of cure as outcome, assessed by colposcopy, biopsy, cytology, and/or visual inspection with acetic acid (VIA), and minimum 6 months follow-up.Data Collection And AnalysisPooled proportions of cure are presented stratified per treatment modality, type of lesion, and region.Main ResultsPooled cure proportions for cryotherapy and thermal coagulation, respectively, were 93.8% (95% CI, 88.5-97.7) and 91.4% (95% CI, 84.9-96.4) for CIN 1; 82.6% (95% CI, 77.4-87.3) and 91.6% (95% CI, 88.2-94.5) for CIN 2-3; and 92.8% (95% CI, 85.6-97.7) and 90.1% (95% CI, 87.0-92.8) for VIA-positive lesions. For thermal coagulation of CIN 2-3 lesions in LMICs 82.4% (95% CI, 75.4-88.6).ConclusionsBoth cryotherapy and thermal coagulation are effective treatment modalities for CIN lesions in LMICs.© 2019 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

21 keywords...

hide…