Print Email Facebook Twitter A systematic review and meta-analysis of thermal coagulation compared with cryotherapy to treat precancerous cervical lesions in low- and middle-income countries Title A systematic review and meta-analysis of thermal coagulation compared with cryotherapy to treat precancerous cervical lesions in low- and middle-income countries Author de Fouw, Marlieke (Leiden University Medical Center) Oosting, R.M. (TU Delft Medical Instruments & Bio-Inspired Technology) Rutgrink, Amy (Leiden University Medical Center) Dekkers, Olaf Matthijs (Leiden University Medical Center) Peters, Alexander Arnold Willem (Leiden University Medical Center) Beltman, Jogchum Jan (Leiden University Medical Center) Date 2019 Abstract Background: Thermal coagulation is gaining popularity for treating cervical intraepithelial neoplasia (CIN) in screening programs in low- and middle-income countries (LMICs) due to unavailability of cryotherapy. Objectives: Assess the effectiveness of thermal coagulation for treatment of CIN lesions compared with cryotherapy, with a focus on LMICs. Search strategy: Papers were identified from previous reviews and electronic literature search in February 2018 with publication date after 2010. Selection criteria: Publications with original data evaluating cryotherapy or thermal coagulation with proportion of cure as outcome, assessed by colposcopy, biopsy, cytology, and/or visual inspection with acetic acid (VIA), and minimum 6 months follow-up. Data collection and analysis: Pooled proportions of cure are presented stratified per treatment modality, type of lesion, and region. Main results: Pooled cure proportions for cryotherapy and thermal coagulation, respectively, were 93.8% (95% CI, 88.5–97.7) and 91.4% (95% CI, 84.9–96.4) for CIN 1; 82.6% (95% CI, 77.4–87.3) and 91.6% (95% CI, 88.2–94.5) for CIN 2–3; and 92.8% (95% CI, 85.6–97.7) and 90.1% (95% CI, 87.0–92.8) for VIA-positive lesions. For thermal coagulation of CIN 2–3 lesions in LMICs 82.4% (95% CI, 75.4–88.6). Conclusions: Both cryotherapy and thermal coagulation are effective treatment modalities for CIN lesions in LMICs. Subject Cervical cancer screeningCervical intraepithelial neoplasiaCryotherapyEffectivenessLow- and middle-income countriesSystematic reviewThermal coagulation To reference this document use: http://resolver.tudelft.nl/uuid:a1545244-836e-4631-bac8-2a845876708a DOI https://doi.org/10.1002/ijgo.12904 ISSN 0020-7292 Source International Journal of Gynecology and Obstetrics, 147 (1), 4-18 Part of collection Institutional Repository Document type review Rights © 2019 Marlieke de Fouw, R.M. Oosting, Amy Rutgrink, Olaf Matthijs Dekkers, Alexander Arnold Willem Peters, Jogchum Jan Beltman Files PDF Fouw_et_al_2019_Internati ... etrics.pdf 1.71 MB Close viewer /islandora/object/uuid:a1545244-836e-4631-bac8-2a845876708a/datastream/OBJ/view