Cold-knife conization with clear margins is an adequate method to definitively treat CINIII.
Grade III CIN is a precursor of invasive cervical cancer.
The risk of progression to invasive carcinoma depends on the severity and the size of the CIN lesion, with approximately one-third of women with untreated CIN3 eventually developing invasive cervical cancer.
Women who are treated for cervical intraepithelial neoplasia (CIN) remain at increased risk of developing cervical cancer when compared with women with normal cytology results or women in the general population.
The short term risks of CIN3 recurrence, following excision and ablation, respectively, are approximately 1.6 and 2.9% at six months rising to 3.2% and 7.2% at 12 months.
The risk of invasive cervical cancer remains elevated for decades following treatment for pre-cancer, and particularly for patients older than the age of 50 years.
Continued screening at three-year intervals through age 65 and a minimum of 25 years after the treatment with the option to be continued as long as the individual remains in good health.
In a retrospective cohort study in 80,442 women with a CIN3 diagnosis.
After a median follow-up of 15.8 years and 1,278,297 person years, 1,554 women (1.9%) developed recurrent CIN3 and 397 women (0.5%) cervical cancer.
Women with CIN3 had a twofold increased risk of cervical cancer when compared with the general female population: risk was highest between 5 and 9 years of follow-up.
Increased risk of cervical cancer was seen at up to 20 years, but this seems to be mostly attributable to aging.
Women with recurrent CIN3 had a ninefold increased risk of developing cervical cancer, while women aged 50 and older at CIN3 diagnosis had a sevenfold increased risk.
Women older than 60 had a sixfold greater incidence of cervical cancer, suggesting that women treated for CIN3 need long-term follow-up program, as well as that screening only until age 60.