Recent research from the UC Davis Center for Healthcare Policy and Research has found that women who have previously been treated for cervical intraepithelial neoplasia (CIN), also known as cervical dysplasia, are more prone to contracting the disease a second time or developing invasive cervical cancer.
The data from the study starting in 1986 encompasses a total of 37,142 women from the British Columbia Cancer Agency who were previously treated for varying degrees of CIN. The study also looks at a comparative population of 71,213 women who were never treated for, nor had CIN.
“We looked at the rate of recurrence of abnormal biopsy in both groups and we looked to see the age of the women, what they were treated with and the original grade of the abnormality affected the recurrence rate,” said Joy Melinkow, author of the study and [doctor at The Department of Family and Community Medicine, Center for Healthcare Policy and Research at UC Davis.
The varying grades of the disease were each treated differently. The women who were affected with a grade two or three of the disease had cone biopsy, loop electrosurgical excision procedure, laser excision or vaporization, or cryotherapy treatment – the freezing of abnormal cells. Women with grade one of the disease could undergo optional treatment.
“Women who had been treated over and especially in the first six years had a higher rate of recurrence than the women that were never treated. And the highest rate of recurrence was in women who had been treated when they had a higher grade, treated with a freezing treatment, and were over 40,” Melinkow said.
The results show that women in the CIN sample were younger than the women in the control sample, whose treatment was often for a CIN with a grade of three.
“It’s not surprising that a more severe abnormality would be more likely to occur. The freezing treatment would be more likely to have recurrences than excision, one reason being that the freezing did not completely eliminate the abnormal cells,” Melinkow said.
Melinkow pointed out that the study helps to guide future treatment in patients who have been previously diagnosed.
UC Davis has the only cancer center in inland Northern California designated by the National Cancer Institute. The center cares for an estimated 9,000 adults and children each year from throughout the Central Valley and inland Northern California, said Dorothy Griffith-Pease, spokesperson for the National Cancer Institute in an e-mail interview.
“Joy Melnikow’s work in cervical cancer is an important component of the cancer center’s work to better understand long-term risks associated with certain cancers – research which ultimately can guide and improve treatment options,“ Griffith-Pease said.
Melinkow’s research could potentially help doctors to understand cancer’s effects and the potential dangers present in incorrectly treating the preliminary effects of the disease.
SADAF MOGHIMI can be reached at campus@theaggie.org.
