THURSDAY, April 28 (HealthDay News) -- Women who have been
treated for precancerous cervical lesions should see their cancer
risk drop to normal after three "all clear" screening test results,
Dutch researchers say.
These women can then resume screening for cervical cancer on the
same schedule as the general population, they added.
"The question is how we should follow women who have been treated for precancerous cervical lesions," said lead researcher Dr. Chris Meijer, from the department of pathology at Vrije University Medical Center in Amsterdam.
The answer appears linked to two years worth of normal test
results following treatment.
In the study, Meijer's team looked at the effectiveness of
follow-up screening among 435 women who were treated for
precancerous cervical lesions between July 1988 and November 2004.
The women were given Pap tests to screen for cervical cancer and
also tested for a virus linked to the cancer -- human
papillomavirus, or HPV -- at 6, 12 and 24 months after treatment.
If the test results were normal, they resumed normal testing, which
in the Netherlands is once every five years.
The risk of developing new precancerous cervical lesions or
cervical cancer over five years was 16.5 percent.
However, among women who had three normal Pap and HPV tests, the
risk dropped to 3 percent in the same period, which is the same
risk seen in women who never had precancerous cervical lesions, the
In addition, Meijer's group found that adding HPV testing made
the one year screening unnecessary for women who had had a negative
test at six months.
Women treated for precancerous cervical lesions who develop
recurring disease need to be screened with Pap and human
papillomavirus testing, but the best regimen for long-term
follow-up hasn't been clear, the researchers said.
The report was published in the April 27 online edition of
The Lancet Oncology.
The American Congress of Obstetricians and Gynecologists
recommends that women aged 21 to 30 be screened for cervical cancer
every two years and that women over 30 who have had three negative
(normal) Pap and HPV tests in a row be screened every three
Meijer thinks that even though the protocol for screening women
over 30 in the United States is every three years, it can safely be
extended to five years.
However, women who have abnormal tests after treatment need
additional testing, because their risk of developing the disease
again is high over the next five years, Meijer noted.
Commenting on the study, Dr. Elizabeth A. Poynor, a gynecologic
oncologist and pelvic surgeon at Lenox Hill Hospital in New York
City said that "this provides a framework for how to follow people
after they have been treated for precancerous cervical
For Poynor, the important message is that if a women does not
have a recurrence after two years, her risk of developing
precancerous cervical lesions reverts to the same risk as women who
have never had precancerous cervical lesions -- that is, they have
the same risk as other women in the general population.
"These women can go back to accepted population screening in the United States, which is a little bit more stringent [than that in the Netherlands]," she said. "Women two years after being appropriately treated for precancerous cervical lesions can be reassured that they go back down to a population risk."
For more information on cervical cancer, visit the
U.S. National Cancer Institute.