Treatment of cervical precancerous lesions

What is the purpose of the treatment?, What treatments are there available?, How is the most appropriate method selected?, What happens if HSIL or CIN2/3 lesions are discovered during pregnancy?

What is the purpose of the treatment?

The purpose of the treatment is to destroy or remove not only the precancerous lesions but the entire transformation zone.

The reason is simple. The transformation zone is the cervical area where HPV causes cancer. Its removal is therefore considered imperative.

Frequently, after the transformation zone is removed and the tissue is examined under the microscope, the lesions that are found are more serious than what the Pap test or the colposcopic biopsies had showed.

What treatments are there available?

We distinguish between removal methods and destruction methods:

Excisional (removal) methods:

  • LEEP
  • Laser conization
  • Cold knife conization

Ablative (destruction) methods:

  • Laser
  • Cryotherapy

How is the most appropriate method selected?

The best method is chosen by the doctor, based on the patient's best interest. The parameters that help him decide correctly are the severity of the lesions, the patient's age and the risk for underlying cancer, and the patient's future fertility.

Excisional methods are selected if the removed tissue must be examined because we suspect that there may be more serious underlying lesions. Among removal methods, LEEP is used more frequently.

What happens if HSIL or CIN2/3 lesions are discovered during pregnancy?

If we are certain about the diagnosis and we don't have any suspicion of underlying cancer, we must follow up the lesions, and they must be treated after the pregnancy.