Does histological incomplete excision of cervical intraepithelial neoplasia following large loop excision of transformation zone increase recurrence rates? A six year cytological follow up

Objective To determine the risk of recurrent cervical intraepithelial neopl asia (CIN) in women with complete or incomplete excision of cervical intrae pithelial neoplasia treated by large loop excision of transformation zone ( LLETZ). Design A retrospective study. Setting One consultant-led colposcopy clinic at Leicester Royal Infirmary Population Three hundred and ninety-four women referred consecutively to th e colposcopy clinic between 1991 and 1992. Main outcome measures The histological recurrence rate of GIN, length of cy tological follow up following treatment related to degree of completeness o f excision at initial treatment. Results Three hundred and twenty-two women had complete cytological or hist ological follow up. The mean length of follow up was 73 months with a mean number of six smears. Women with incomplete excision of CIN had a significa ntly higher risk of recurrent CIN (relative risk 8.23) occurring in a signi ficantly shorter time compared with women with complete excision. Conclusions This study demonstrates that large loop excision of transformat ion zone is successful in over 95% of cases. Cytological surveillance is sa tisfactory for follow up of women who have complete excision of GIN. Women with incomplete excision of CIN at initial LLETZ remain at significant risk of developing further CIN and long term colposcopic and cytological follow up is necessary.