Surgery not always best option for women with abnormal cervical cancer test results

Only 0.5 per cent of cases progressed to cervical cancer and surgery can have complications for giving birth in future

Alex Matthews-King
Health Correspondent
Tuesday 27 February 2018 23:34 GMT
Cervical cancer screening rates are at a 19 year low and experts say tackling this is key to boosting survival
Cervical cancer screening rates are at a 19 year low and experts say tackling this is key to boosting survival (Rex)

Thousands of women may be having unnecessary treatment to remove abnormal cervical growths which might never become cancer and often go away on their own, scientists have said.

Around half of women in a new study who were identified with “moderate” lesions on their cervix saw them clear up naturally, and in one-third they stayed the same.

Only one in five cases developed into a more serious type of lesion, which could lead to cancer in future, and only 0.5 per cent were diagnosed with cancer in a two year monitoring period.

The scientists from Imperial College London say that based on this evidence more regular screening would be a better option for these women, instead of immediate removal of the lesion.

This would prevent them having invasive surgery to cut out the affected tissue, a procedure which can cause complications in future births.

It is particularly true in younger women under 30 where the chances of lesions regressing spontaneously was closer to 60 per cent and just 11 per cent of cases progressed to cancer.

While the chance of lesions progressing to cancer is low, opting not to have immediate treatment won’t be acceptable for everyone.

“It still means taking a gamble that surveillance is simply delaying treatment and even a small risk of cancer (0.5% in this study) may still be unacceptable to some”, said Professor Maggie Cruickshank from University of Aberdeen, of the study in The BMJ .

The team from Imperial collected 36 available studies which followed 3,160 women with laboratory confirmed lesions at this “moderate” stage.

Based on these estimates, the researchers explain that in 1000 women aged under 30 with this diagnosis, 600 will experience regression, 230 will remain unchanged, and 110 will progress within two years of active surveillance.

Only 15 cases of cancer were reported, most in women aged more than 30.

Most women attended 90 per cent of the recommended screening programmes over the two year period, which suggest the high surveillance regime could be more effective.

This is important as attendance at regular cervical cancer screening in the UK has fallen to a 19 year low.

“This study provides helpful information for the management of a subgroup of women with this cervical cancer pre-cursor,” said Mr John Butler, a consultant gynaecological oncology surgeon at the The Royal Marsden NHS Foundation Trust who was not involved with the study.

“Standard management involves excision of the lesion which may be associated with complications from the procedure and any future pregnancies”.

However UK cancer survival rates already lag behind other comparable countries, and Mr Butler added: “Therefore whilst this study is of importance to a some patients who are considering their treatment options it is essential that every step is taken to maximise attendance at cervical cancer screening particularly in younger patients.”

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