Aim: Several new technologies have been introduced in clinical practice for treatment of cervical intraepithelial neoplasia (CIN). This article will review the current therapies and their outcomes. Screening of all women in the age group of 30–65 will result in a certain number of screen positive women, who will then need a proper management. The management will depend on the type of lesion and clinical assessment of the patient.
Material and methods: The current modalities of management available are cryotherapy, large loop excision of transformation zone (LLETZ), thermoablation, carbon dioxide (CO2) laser, and cold knife conization (CKC). Each therapy has its own advantages and disadvantages. One has to choose the correct modality for each individual case. There is also the issue of availability and affordability for each patient. The treating physician will also be confident of the procedure in which he has experience. All modalities of the treatment are simple, rarely require anesthesia and hospitalization. Centers for treatment of CIN must be widely made available in smaller towns.
Results: Each modality will be individually discussed and the literature on each will be reviewed. In this review, WHO guidelines are usually followed.
Discussion: The management of CIN is long-term, and a life-time follow-up is recommended.
There are some special groups of women who need special attention. These include adolescent girls, pregnant women, immuno-compromised persons, and women with other health conditions.
Conclusion: In the case of a revised diagnosis of invasive cancer on biopsy of a case diagnosed as CIN, the treatment will have to be also revised. It is also necessary not to alarm the patient and her family, but to give them ample time to arrange for the treatment.
Clinical significance: WHO's call for “elimination of cervical cancer” which was launched in 2018 gives a sense of urgency to the understanding of these therapies. When the screening will be extensive, a large number of CIN will be detected. They will all need correct treatment and follow-up. Each gynecologist must know what to suggest and where to refer such a case. This article will fulfill that need.
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