Evaluation of ‘See and Treat’ Policy by Loop Electrosurgical Excision Procedure (LEEP) in Treating Cervical Intraepithelial Neoplasia (CIN)

Abstract

Background: Cervical intraepithelial neoplasia (CIN) is a pre-cancerous lesion of uterine cervix. “See and treat policy of CIN” – is a one-step procedure where evaluation and treatment of CIN cases are performed at the same sitting. In this policy, screen positive patients are referred to colposcopy and are treated with Loop Electrosurgical Excision Procedure (LEEP) or. Objective: Aim of this study was to evaluate the accuracy of colposcopy in diagnosis of CIN and also to determine the efficacy and safety of LEEP for the treatment of CIN. Materials and methods: This longitudinal study was performed at Obstetrics & Gynaecology department of Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh, from July 2019 to June 2020. In this study, 30 patients were included according to selection criteria. Results: Most of the participants (50%) were in the 40-49 years old age group. Out of 30 participants, 16 (53.3%) had high grade CIN and 14 (46.7%) had low grade CIN on colposcopy. According to the biopsy report 26.7% had negative result whereas 13.3%, 46.7%, 10.0% and 3.3% had CIN I, CIN II, CIN III and micro invasive cancer respectively. During follow up, colposcopy revealed 93.3% to be normal, 3.3% had inflammation/infection and low-grade CIN each. Conclusion: A single visit approach using VIA, colposcopy followed by LEEP can help to reduce cervical carcinoma in a low resource country like ours though there is possibility of over-treatment in few cases.

Delta Med Col J. Jan 2023;11(1):22-27