Method for Treating Cervical Lesions May Pose Pregnancy Risks

But at least two women's health experts cautioned about drawing conclusions from a study that involved pooling of data from multiple retrospective studies. And one warned about comparing obstetrical results among procedures used to treat different types of lesions, or tissue abnormalities.

"The appropriate study that would answer the question would be to compare LEEP and laser used for the same kind of lesion and the same size lesion done all at one institution," said Dr. Annekathryn Goodman, associate professor of obstetrics, gynecology and reproductive biology at Harvard Medical School.

That said, Goodman underscored the importance of tailoring the treatment to the type of lesion: "So, small lesions only need small procedures, and larger lesions need big procedures." And, she added, "If the wrong treatment is done, and the lesion is not completely removed, the woman is at high risk for developing a cancer."

In her view, LEEP should be limited to treating women with high-grade precancerous lesions.

Dr. Carolyn D. Runowicz, director of the Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center, agreed that LEEP is needed to treat women with significant lesions to prevent an invasive cervical cancer. Women should also get a second opinion before undergoing a procedure, she said.

But the larger message, according to Runowicz, is for patients to prevent these lesions by getting regular screenings for cervical cancer.

And with the U.S. Food and Drug Administration's 2006 approval of Gardasil, a vaccine to prevent cervical cancer, woman have a powerful weapon against lesions caused by the human papillomavirus (HPV).

"HPV vaccine is the answer," agreed Dr. Joan L. Walker, chief of gynecologic oncology at the University of Oklahoma Health Sciences Center.

More information

For more on LEEP, visit the American College of Obstetricians and Gynecologists.

SOURCES: Annekathryn Goodman, M.D., associate professor, obstetrics, gynecology and reproductive biology, Harvard Medical School, Boston; Carolyn D. Runowicz, M.D., director, Carole and Ray Neag Comprehensive Cancer Center, University of Connecticut Health Center, Farmington; Joan L. Walker, M.D., chief, gynecologic oncology, University of Oklahoma Health Sciences Center, Oklahoma City; American College of Obstetricians and Gynecologists, Washington, D.C.; U.S. Food and Drug Administration press release;The Lancet