Cryotherapy
Cryotherapy, or freezing cervical tissue that is likely to develop into cancer, can be
used to treat precancer among women who have been screened using Pap, VIA or
HPV DNA testing. The procedure does not require electricity, and is both cheaper
and technicall y s impl er than other treatment options .
Cryotherapy has been proven effective and safe in multiple studies and can be done
either in a single-visit approach or at a convenient referral site. A systematic
literature review, including 32 studies of cryotherapy effectiveness, found an overall
cure rate of 89.5% for all grades of cervical intraepithelial neoplasia ( CIN) after one
cryotherapy treatment at 12 months post-treatment.
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More recent studies of
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Cervical Cancer Action Coalition | New Options for Cervical Cancer Screening and Treatment
cryotherapy following VIA or HPV DNA testing have achieved similar results. A
project in Peru reported cure rates over 90% for CIN 1 and 2 and 70% for CIN 3
within three years of cryotherapy treatment
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and a study in South Africa found
cure rates of over 90%. A separate study in India found similar cure rates even
when nurses, rather than physicians, provided cryotherapy in field clinics.
Regarding safety, the 2003 systematic review and a 2009 updated review suggest
that major complications, such as severe bleeding and Pelvic Inflammatory Disease
(PID), are very unlikely events following cryotherapy and occur less often than after
LEEP or laser ablation treatment.
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For example among almost 950 women in
South Africa who received cryotherapy treatment after a positive HPV DNA or VIA
test, only one serious adverse event occurred ( a woman who refused hospital
treatment for cervical bleeding) .
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Efforts are needed to ensure that adequate
numbers of effective, affordable cryotherapy units are accessible to cervical cancer
prevention programs worldwide.