Management of gynecologic patients with precancerous disease

Dae-Hoon Jeong; Kyung-Bok Lee; Ki-Tae Kim

doi:10.5468/kjog.2010.53.4.291

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Jeong, Lee, and Kim: Management of gynecologic patients with precancerous disease

Recent Clinical Review

Korean Journal of Obstetrics and Gynecology

Korean Journal of Obstetrics and Gynecology 2010; 53(4): 291-302.

Published online: 30 April 2010

DOI: https://doi.org/10.5468/kjog.2010.53.4.291

Management of gynecologic patients with precancerous disease

Dae-Hoon Jeong, M.D.^1,², Kyung-Bok Lee, M.D.¹, Ki-Tae Kim, M.D.^1,²

¹Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

²Paik Institute for Clinical Research, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

Corresponding author (obgynjeong@hanmail.net)

Received 17 November 2009 Accepted 29 December 2009

Abstract

Cervical cancer of gynecologic cancer is considered a preventable disease because it has a long preventive state, cervical cytology screening programs are currently available, and treatment of precancerous lesions is effective. Proper management of precancerous disease is important because improper management of precancerous disease can increase risk of invasive cancer on the one hand and can result in complications from overtreatment on the other. The decision as to which therapeutic option to use in an individual patient depends on considerations such as patient age, parity, desire for future childbearing, preferences, prior cytology and treatment history, and history of default from follow-up, operator experience, and nonvisualization of the transformation zone.

Keywords: Cervical intraepithelial neoplasia, Vulva intraepithelial neoplasia, Vaginal intraepithelial neoplasia, Management

Figures and Tables

Figure 1

Management of women with a histological diagnosis of cervical intraepithelial neoplasia grade 1 (CIN 1) preceded by atypical squamous cells (ASC)-US, ASC-H, low-grade squamous intraepithelial lesion (LSIL) cytology.

Figure 2

Management of women with a histological diagnosis of cervical intraepithelial neoplasia grade 1 (CIN 1) preceded by high-grade squamous intraepithelial lesion (HSIL) or atypical glandular cells not otherwise specified (AGC-NOS) cytology.

Figure 3

Management of adolescent women (20 years and younger) with a histological diagnosis of cervical intraepithelial neoplasia grade (CIN) 1.

HSIL: high-grade squamous intraepithelial lesion, ASC: atypical squamous cells.

Figure 4

Management of women with a histological diagnosis of cervical intraepithelial neoplasia grade (CIN) 2, 3.

Figure 5

Management of adolescent and young women with a histological diagnosis of cervical intraepithelial neoplasia grade (CIN) 2, 3.

Figure 6

Management of women with adenocarcinoma in situ diagnosed from a diagnostic excisional procedure.

Table 1

Interventions for vulva intraepithelial neoplasia

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