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Cancer: Cervical & Ovarian Message Board

Cancer: Cervical & Ovarian Board Index

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General Guidelines
Treatment for Cervical Intraepithelial Neoplasia. Treatment of cervical intraepithelial neoplasia (CIN) (including carcinoma in situ) depends on the type and extent of abnormal cellular changes. Some of the treatments for CIN are also used for early-stage cancer.
CIN I lesions often regress and simply require careful follow up to make certain that the Pap smear and colposcopic exam return to normal.

Women with CIN II or CIN III have a finite risk for progression to invasive cancer if these areas are not removed. Therefore, finding CIN II or III is an indication for the removal of the entire extent of the suspicious area, often by an outpatient technique known as the loop electrosurgical excision procedure (LEEP).

If extensive areas of CIN II or III can not be entirely discerned by a colposcopy or if they extend into the mucous membrane in the cervical canal, a more aggressive procedure called conization (cone biopsy) may be performed instead.
Treatment for Adenocarcinoma in Situ. Some controversy exists over the treatment of adenocarcinoma in situ. Adenocarcinomas originate in glandular cells. This cancer tends to be more aggressive than the more common squamous carcinoma in situ. Some evidence suggests that it develops in numerous sites rather than a single location. Hysterectomy is generally recommended. In women who wish to retain fertility, cone biopsies may be performed, although this procedure sometimes causes sterility and it does not always remove all adenocarcinomas.

Follow-Up. Patients treated for CIN require monitoring. Testing for human papillomavirus (HPV) may prove to be useful in determining whether repeat colposcopies may or may not be needed. One study strongly suggested that if both HPV and Pap smear tests are normal on two consecutive visits, then most likely treatment was successful. If either the HPV or Pap smear is abnormal, then it may be reasonable to consider another colposcopy.

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