Loop electrosurgical excision procedures in Israel

Abstract

Aim: To summarize data for cervical loop electrosurgical excision procedures (LEEP) in Israel from 2001 to 2007 inclusive.

Methods: 16 colposcopy specialists in Israel completed yearly questionnaires that assessed their LEEP.

Results: Of the 2,681 LEEP reported, cervical intraepithelial neoplasia 2/3 (CIN 2/3) and CIN 1 were the main indications, with 63.2 and 20.5%, respectively. CIN 2/3 was detected in 111 (20.4%) of those for whom CIN 1 was the indication for LEEP. Of those diagnosed with CIN 2/3 following LEEP, 34.8% (426/1,225) were in the 18- to 34-year age range. The agreement between punch and LEEP biopsies was 80.15% and the κ value was 0.536 (moderate agreement). Complications included severe bleeding in 3.02% during the procedure(s) and 2.99% in the 3 weeks following LEEP.

Conclusions: In one-fifth of the women for whom CIN 1 was the indication for LEEP, CIN 2/3 was the final diagnosis. More than one-third of the cases of CIN 2/3 and carcinoma were diagnosed in women under the age of 35, the age at which Pap screening is offered in Israel. Based on these findings, the Israeli Society of Cervical Pathology and Colposcopy prepared guidelines for the treatment of CIN.