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Women with High-Grade Cervical Precancers at Increased Cancer Risk Later in Life — Physician’s First Watch

Medical News |
January 15, 2014

Women with High-Grade Cervical Precancers at Increased Cancer Risk Later in Life

By Kelly Young

Women previously diagnosed with high-grade cervical intraepithelial neoplasia (CIN) have increased risk for cervical or vaginal cancer as they age, according to a BMJ study.

Using data from Swedish registries, researchers identified 150,000 women who'd been diagnosed with CIN grade 3 from 1958 through 2008. Overall, those who'd had CIN3 were at increased risk for later cervical or vaginal cancer diagnoses, compared with the general female population (standardized incidence ratio, 2.39). Mortality from cervical and vaginal cancer was also higher in women who'd had CIN3.

The risk for cancer incidence and mortality increased with increasing age at CIN3 diagnosis. For example, the standardized incidence ratio for cancer among those aged 50-59 at CIN3 diagnosis was 5.65, and for those aged 60-69, 10.58

Editorialists conclude that the study "makes it clear that women who have been treated for a high-grade intraepithelial cervical lesion, particularly those aged 50 years or more, require careful surveillance, and that measures should be taken to assure full compliance with follow-up."

Reader Comments (1)

Lenora Brace, MN, NP Other, Nurse Practitioner in a Primary Health Care Clinic

If a woman's annual paps for 20 years post treatment for CIN 2 or 3 are negative is it reasonable for screening to be extended to every 3 years? What do you recommend for women in their 80s and 90s with hx of CIN 2&3? From UpToDate: Vaginal cytology for vaginal cancer screening is advisable in women with CIN 2,3 prior to, or diagnosed at the time of, total hysterectomy. The American College of Obstetricians and Gynecologists recommends ongoing screening of these women for at least 20 years after treatment of CIN 2,3. Recurrences in women with positive margins can occur years after treatment. In a retrospective study of women after LEEP, mean time to recurrence in women with positive margins was almost four years.

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