Effectiveness and safety of loop electrosurgical excision procedure for cervical neoplasia in rural India

Objective

To evaluate the effectiveness and safety of loop electrosurgical excision procedure (LEEP) to treat cervical intraepithelial neoplasia (CIN) in rural India.

Method

Women with CIN colposcopic features unsuitable for cryotherapy were treated with LEEP using a “see-and-treat” approach. Women with unsatisfactory colposcopy had diagnostic LEEP. Cure was defined as no clinical or histologic evidence of CIN at 1-year follow-up. Factors influencing cure rates were evaluated by χ² tests.

Results

Of the 1141 women who underwent LEEP (569 see-and-treat; 572 unsatisfactory colposcopy), 634 had histologically proven CIN. Of those, 489 reported for follow-up and 459 (93.9%) had no evidence of disease. Cure rates were 98.1% for women with CIN 1, 93.6% for CIN 2, and 85.0% for CIN 3. Patients with CIN 2-3 had significantly lower cure rates.

Conclusion

Cure rates for LEEP provided by newly trained doctors in rural India were similar to those reported in the gynecological literature.