Pattern of CIN recurrence following laser ablation treatment: long-term follow-up

Chew GK, Jandial L, Paraskevaidis E, Kitchener HC. Pattern of CIN recurrence following laser ablation treatment: Long-term follow-up. Our objective was to study the long-term patern of recurrence of cervical intraepithelial neoplasia (CIN) and development of cervical carcinoma in patients who had been treated with laser ablative treatment. The study design consisted of a retrospective analysis of the case records of 2130 patients who received laser ablation treatment for CIN lesions from 1980-1988, with the years 1980 and 1988 inclusive. All of the 2130 women in the cohort have had at least seven years of follow-up. Of the treated population, 79% remain under regular cytological follow-up at the regional laboratory. Nine percent required further treatment, 52% of this within the first year of treatment, 19% within the second year, 4% in the third, 5% in the fourth and fifth years, and 15% over the next five years. These lesions were detected up to ten years after the initial treatment. No recurrent lesions have yet been detected after ten years, and 0.2% of the cohort have developed cervical carcinoma. Long-term follow-up has demonstrated a continuing incidence of recurrent CIN up to ten years after initial treatment. This emphasizes the need for adherence to follow-up protocol if the incidence of cervical carcinoma post-treatment is to be reduced. The data suggest that annual follow-up for 10 years may be advisable to reduce the risk of post-treatment invasive disease.