Cervical neoplasia treatment is linked to increased cancer risk

  • Kalliala I & al.
  • Ann Oncol
  • 1 Feb 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Women who receive treatment for cervical intraepithelial neoplasia (CIN) show a 3-fold higher risk of developing cervical cancer vs the general population.
  • The incidence rate remains higher even 20 years after the treatment.
  • The risk is higher in older women.

Why this matters

  • Longer follow-up may be warranted for the high-risk population previously treated for CIN.

Study design

  • Meta-analysis of 27 studies including 5726 women treated for CIN.
  • Funding: National Institute for Health Research.

Key results

  • Mean follow-up duration varied from 5 to 27.5 years. 
  • The absolute incidence rate (IR) after treatment of CIN per 100,000 woman-years was 39 (95% CI, 22-69; total of 5,562,889 woman-years).
  • IRs per 100,000 woman-years:
    • 38 within 10 years of treatment,
    • 31 at 10-20 years, and
    • 32 after 20 years.
  • Women treated for CIN showed a higher relative risk (RR) for cervical cancer vs the general population: 3.30 (95% CI, 2.57-4.24).
  • Risk ratio (RR) was higher in older women: 
    • ≥50 years: 7.15 (95% CI, 4.75-10.76); vs  
  • The risk for cervical cancer was higher after excisional treatment (RR, 2.04; 95% CI, 1.88-2.21) vs no treatment, but was not higher with ablative treatment.  

Limitations

  • Heterogeneity across studies.