Efficacy and Acceptability of Thermal Ablation in the Treatment of Cervical Premalignant Lesions

Background: Cervical cancer is the second leading cause of cancer deaths in women in low- and low–middle-income countries. It is preventable through human papillomavirus vaccination, cervical cancer screening, and treatment of precancerous lesions. For low-resource settings, the WHO recommends ablative procedures: cryotherapy and thermal ablation (TA). Aim: The aim of the study was to evaluate the efficacy and acceptability of TA in the treatment of cervical premalignant lesions. Methodology: In the study, women with positive cervical screening test or unhealthy cervix referred for colposcopy, having acetowhite lesions followed by biopsy were counseled for TA at the same sitting. After treatment, women rated the level of pain experienced during treatment using the Wong–Baker FACES pain rating scale from 0 to 10. Short-term safety outcomes that could require medical attention were assessed 1 month after treatment. They were called after 1 year for follow-up. RStudio Version 1.2.1093 was used (Work on data analysis, statistical modeling, and programming tasks) for statistical analysis. Results: Results showed that TA was done in 100 women; 93 had cervical intraepithelial neoplasia (CIN) 1, 4 had CIN 2, and 3 had ectropion. The most common side effect during the procedure was cramping pain in 70%, the average pain rating at the time of treatment was 2, and 96% rated their pain levels as <6. When asked if they would recommend this treatment, all women said they would. At the 1-month follow-up visit, the most common reported side effect was discharge (77%), blood-stained discharge in 7%, and dysuria in 4%. However, none of them required medical attention. On follow-up at 1 year, 98% had no recurrence; two women had persistent CIN and had large loop excision of the transformation zone. Conclusions: It was observed that TA is safe and acceptable to patients as a treatment option for precancerous cervical lesions in low-resource settings.