Persistent minor smear abnormalities: is large loop excision of the transformation zone (LLETZ) the solution?

Abstract

This prospective observational study was carried out to evaluate the efficacy of large loop excision of the transformation zone (LLETZ) as a management strategy for women with four or more smears showing borderline changes or mild dyskaryosis. A total of 102 women with four or more smears showing minor abnormalities and no colposcopic evidence of high-grade disease opted to undergo LLETZ in preference to continued cytological surveillance. Histology of the LLETZ specimens showed 11 cases of CIN2/3, one CGIN, 32 CIN1 and 10 HPV changes. In 97 of the 102 (95%) women, the follow-up cervical smear reverted to negative.

Long-Term Persistence of Prevalently Detected Human Papillomavirus Infections in the Absence of Detectable Cervical Precancer and Cancer

“…One study [23] that excised the cervical tissue of 102 women following >4 borderline or mildly abnormal smears and no colposcopic evidence of high-grade disease found only 11 cases (11%) of undiagnosed CIN2/3. Thus, although immediate excision provides the greatest safety, almost 90% of women would be overtreated.…”