LEEP (Loop Electrosurgical Excision procedure)

Women with high-grade Papanicolaou (Pap) smears had a 45-65 percent chance of developing moderate–high-grade intraepithelial neoplasia on biopsy and a 2% chance of developing invasive cancer. Inconsistencies between Pap smear cytology and cervical biopsy histopathology, on the other hand, can create a clinical challenge. Patients with a High-Grade Squamous Intraepithelial Lesion Pap smear and cervical biopsies with Cervical Intraepithelial Neoplasia 1 histology or less are considered discrepant. When no disease or Cervical Intraepithelial Neoplasia 1 is discovered with acceptable colposcopy, the American Society for Colposcopy and Cervical Pathology formerly recommended an excisional technique for diagnosis in nonpregnant women. More patients are choosing conservative care as we gain a better understanding of Human papillomavirus infection, its course of the disease, and outcomes.

Because there is a concern that the high-grade lesion discovered on Pap smear was overlooked on the biopsy, a loop electrosurgical excisional technique (LEEP) is a suitable therapy choice for this discrepancy in non-adolescent patients. However, we know that up to 34% of women with High-Grade Squamous Intraepithelial Lesion will naturally regress, negating the need for an excisional technique. There hasn't been any research on how the period between the initial High-Grade Squamous Intraepithelial Lesions cytology and the LEEP affects the risk of identifying substantial pathology in the LEEP sample.

The goal of the studies was to see if the period between the initial High-Grade Squamous Intraepithelial Lesion Pap smear and the LEEP for discrepancy influences the pathologic grade of cervical intraepithelial neoplasia in the LEEP material. We expected that the likelihood of identifying Cervical Intraepithelial Neoplasia 2 and 3 in the LEEP sample would reduce as the time elapsed between the original High-Grade Squamous Intraepithelial Lesions Pap and later LEEP for discrepancy grew.