Watch or Remove? Study Finds One Option May Be Better for Abnormal Cervical Lesions

Watch or Remove? New Study Reveals Which Option is More Effective for Treating Abnormal Cervical Lesions

New Study Which is better for abnormal cervical lesions, watching or removing?

When abnormal cervical cells are detected during a gynecological exam, it may be safer to remove them right away rather than “actively survey” the lesions and leave them in place, according to exciting new research. Imagine if you discovered a suspicious stain on your favorite shirt. Would you leave it and hope it disappears magically, or would you take proactive measures to tackle it head-on? The same logic can be applied to abnormal cervical lesions.

In a study of over 27,500 Danish women, those who opted for active surveillance had higher long-term risks for cervical cancer, compared to women who had these suspicious lesions removed. Now, don’t you dare underestimate the importance of this finding! It could greatly impact future guidelines on the management of cervical intraepithelial neoplasia grade 2 (CIN2) and the counseling of women with this diagnosis.

CIN2, also known as precancerous cervical cell growth, has been the subject of much controversy. On one hand, these lesions can be the stepping stones to cervical cancer or simply regress and become harmless within two years. It’s like a game of roulette, where the lesions might either transform into potential danger or miraculously dissipate. The question is, are you willing to take that gamble?

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It’s understandable to have concerns about over-treatment, as excising all the lesions may seem like cutting away half of your perfectly fine shirt just to remove that one pesky stain. Additionally, studies have indicated a possible link between surgical removal of CIN2 lesions and a higher risk of preterm birth if a woman becomes pregnant. So, the medical world introduced the concept of “active surveillance” as an option for younger women diagnosed with CIN2. It’s like keeping a watchful eye on the stain, hoping it doesn’t spread or wreak havoc.

However, let’s dive into the fascinating details of this study! Researchers tracked the outcomes of 27,500 Danish women aged 18 to 40 who were diagnosed with CIN2 between 1998 and 2020. Interestingly, 55% of them opted for immediate removal of the lesions, while the others chose active surveillance, with periodic follow-up exams.

Now, fast forward to the end of 2020 — a total of 104 cases of cervical cancer emerged in the entire group. Among these cases, 56 belonged to the active surveillance group, and 48 occurred in women who had their lesions removed. At first glance, you might assume that both groups faced similar odds of developing cervical cancer within two years after diagnosis. However, brace yourself for the shocking twist!

By the time the 20-year mark arrived, those in the active surveillance group had a four times higher risk of developing cervical cancer compared to their counterparts who had their CIN2 lesions surgically removed. It’s like the difference between leaving a stubborn stain to grow and transform into an unrecognizable monster, or diligently taking swift action to vanquish it and maintain the pristine condition of your shirt.

The study, published on November 29 in the prestigious BMJ journal, doesn’t stop there with its captivating findings. The researchers suggest that the human papillomavirus (HPV), responsible for most cervical cancer cases, may be less active in women who undergo immediate removal of CIN2 lesions. It’s like eradicating the source of potential mischief before it wreaks havoc on your shirt. However, in cases where the lesions are left intact, the HPV may reactivate and trigger an undesirable series of events, including the dreaded cancer.

Now, before you panic, it’s important to note that the absolute risk of developing cervical cancer for any individual patient remains very low, regardless of the chosen treatment. But these findings are like the secret decoder ring to guide us on the best decision-making process for CIN2 treatment, considering factors such as age and reproductive desires. It’s time for doctors and patients alike to engage in a shared discussion of the long-term risks involved after completing planned pregnancies.

So, dear readers, I urge you to stay informed and make proactive choices regarding your health. Whether it’s dealing with a rebellious stain on your favorite shirt or deciding how to manage abnormal cervical lesions, remember that knowledge is power. Let’s work together to ensure a bright and healthy future for all. After all, who wouldn’t want a crisp, spotless shirt? Now, go forth and conquer those stains, both on your clothes and in your life!

More information

Find out more about CIN2 at the Cleveland Clinic.

SOURCE: BMJ, Nov. 29, 2023

What This Means For You

If a gynecologic exam turns up a precancerous lesion known as CIN2, immediate excision might be the better option, new research suggests.

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