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A systematic review and meta‐analysis of thermal coagulation compared with cryotherapy to treat precancerous cervical lesions in low‐ and middle‐income countries
Background: Thermal 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.
Objectives: Assess the effectiveness of thermal coagulation for treatment of CIN lesions compared with cryotherapy, with a focus on LMICs.
Search strategy: Papers were identified from previous reviews and electronic literature search in February 2018 with publication date after 2010.
Selection criteria: Publications 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 analysis: Pooled proportions of cure are presented stratified per treatment modality, type of lesion, and region....
Show moreBackground: Thermal 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.
Objectives: Assess the effectiveness of thermal coagulation for treatment of CIN lesions compared with cryotherapy, with a focus on LMICs.
Search strategy: Papers were identified from previous reviews and electronic literature search in February 2018 with publication date after 2010.
Selection criteria: Publications 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 analysis: Pooled proportions of cure are presented stratified per treatment modality, type of lesion, and region.
Main results: Pooled 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).
Conclusions: Both cryotherapy and thermal coagulation are effective treatment modalities for CIN lesions in LMICs.
Show less- All authors
- Fouw, M. de; Oosting, R.M.; Rutgrink, A.; Dekkers, O.M.; Peters, A.A.W.; Beltman, J.J.
- Date
- 2019
- Pages
- 1 - 15