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Loop electrosurgical excision procedures in Israel.

Efraim Siegler1, Jacob Bornstein,

  • 1Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel.

Gynecologic and Obstetric Investigation
|August 11, 2011
PubMed
Summary

Loop electrosurgical excision procedures (LEEP) for cervical intraepithelial neoplasia (CIN) in Israel revealed significant underdiagnosis of CIN 2/3 when CIN 1 was the initial indication. Many younger women were diagnosed with CIN 2/3.

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Area of Science:

  • Gynecology
  • Oncology
  • Public Health

Background:

  • Cervical intraepithelial neoplasia (CIN) is a precursor to cervical cancer.
  • Loop electrosurgical excision procedures (LEEP) are a common treatment for CIN.
  • Understanding LEEP indications and outcomes is crucial for cervical cancer prevention.

Purpose of the Study:

  • To summarize data on cervical loop electrosurgical excision procedures (LEEP) in Israel between 2001 and 2007.
  • To analyze indications, diagnoses, and complications associated with LEEP procedures.
  • To inform cervical pathology and colposcopy guidelines.

Main Methods:

  • Data collected from 16 colposcopy specialists in Israel via yearly questionnaires.
  • Analysis of 2,681 reported LEEP procedures.

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  • Assessment of indications, final diagnoses, age distribution, biopsy agreement, and complication rates.

    • Main Results:

    • Cervical intraepithelial neoplasia 2/3 (CIN 2/3) and CIN 1 were the primary indications for LEEP (63.2% and 20.5%).
    • CIN 2/3 was found in 20.4% of cases initially indicated for CIN 1.
    • Severe bleeding occurred in approximately 3% of procedures.
    • 34.8% of CIN 2/3 cases were diagnosed in women aged 18-34.

    Conclusions:

    • A significant proportion of women with an initial CIN 1 indication were ultimately diagnosed with CIN 2/3.
    • A substantial number of CIN 2/3 and carcinoma cases were identified in women under 35.
    • Findings led to the development of new guidelines by the Israeli Society of Cervical Pathology and Colposcopy.