Abbreviated surveillance safe after treatment of high-grade cervical dysplasia

Traditional surveillance intervals for women treated for high-grade squamous intraepithelial lesions can be safely lengthened, according to a report in the March issue of Obstetrics and Gynecology. Two screenings, rather than three or four, during the first year seem adequate.

In a study at the University of North Carolina in Chapel Hill, North Carolina, Dr. Elizabeth N. Skinner and colleagues reviewed data on 546 women treated over a 10-year period with loop excision for high-grade squamous epithelial lesions. They found that during 2 years of post-procedure surveillance, 13% of the women developed recurrent cervical intraepithelial neoplasia 2 or 3. Most of the recurrences presented during the first 6 months and between months 22 and 24. The recurrence rate “…was dramatically lower during months 7 to 21,” the investigators found. According to the article, existing guidelines from the American College of Obstetrics and Gynecology advise that women treated for preinvasive lesions should have cytologic evaluations every 3 to 4 months for the first year after treatment, and then annually. Based on their findings, however, the researchers suggest, “A clinically and financially optimal surveillance schedule for women treated with loop excision for high-grade dysplasia would be to obtain Pap tests every 6 months for 1 year and then return to annual screening.” They conclude, “Lengthening the surveillance intervals could be beneficial to patients, while decreasing healthcare costs, without compromising the ability to detect and treat recurrent disease.”(Source: Obstet Gynecol 2004;103:488-492: Reuters Health: March 2004: Oncolink)