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Loop diathermy excision compared with cervical laser vaporisation for the treatment of intraepithelial neoplasia: a
1Centre for Cancer Epidemiology, Withington, Manchester, UK.
Objective:
To determine whether loop diathermy excision of the transformation zone and laser vaporisation are equally effective in the treatment of cervical intraepithelial neoplasia.
Design:
Randomised controlled trial.
Population:
Women referred for evaluation of cytological abnormality who were considered suitable for outpatient local destructive treatment.
Setting:
Seven colposcopy units in the North West Region.
Methods:
Loop diathermy excision of the transformation zone and laser vaporisation.
Main Outcome Measure:
Smear reported as moderate dyskariosis or worse following treatment.
Results:
Of 289 women randomised, 285 had one or more smears following treatment. Women were more likely to have a smear reported as moderate dyskariosis or worse following laser vaporisation [hazard ratio 3.01 (95% CI 1.27 to 7.12)]. The cumulative risk of a smear reported as moderate dyskariosis or worse was 6.0% at six months and 12.1% at three years in those allocated laser vaporisation, and 2.0% at six months, and 3.3% at three years in those allocated loop diathermy excision of the transformation zone.
Conclusions:
Loop diathermy excision is a more effective treatment of cervical intraepithelial neoplasia than laser vaporisation.
