A comparison of cryocauterisation, laser vaporisation and large loop excision of the transformation zone for the treatment of cervical intraepithelial neoplasia

Summary

Three groups of approximately 200 women each, who received primary treatment for cervical intraepithelial neoplasia (CIN) by either cryocauterisation, laser vaporisation or large loop excision of the transformation zone (LLETZ) were compared to assess treatment efficacy. Post-treatment follow up smears were performed at 4 and 10 months and then yearly for 5 years. Cure was defined as the absence of abnormal smears during the entire period of follow up.

The overall cure rates and mean duration of follow up were as follows: cryocauterisation—71·7 per cent and 5·45 years; laser vaporization—65 per cent and 3·84 years; and LLETZ—87 per cent and 2·32 years. At 10 months following treatment the cure rate with LLETZ was significantly better than that with cryocauterisation (P = 0.003) and laser vaporisation (P < 0.0001). Significant differences were observed in the distribution of age and the histological grade of the disease between the three treatment groups, but only the latter had an effect on cure rates.