Outcomes associated with large loop excision of the cervical transformation zone in women 60–64 years of age: A population‐based register study from Denmark

Abstract Introduction For women treated for cervical dysplasia at 60–64 years in Denmark, we reported the frequency of abnormalities before and after treatment of cervix uteri (most frequently performed as large loop excision of the cervical transformation zone, LLETZ) using population‐based real‐wo...

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Main Authors: Julie Laub Erdal, Reza Rafiolsadat Serizawa, Matejka Rebolj, Jeppe Bennekou Schroll
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.15111
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author Julie Laub Erdal
Reza Rafiolsadat Serizawa
Matejka Rebolj
Jeppe Bennekou Schroll
author_facet Julie Laub Erdal
Reza Rafiolsadat Serizawa
Matejka Rebolj
Jeppe Bennekou Schroll
author_sort Julie Laub Erdal
collection DOAJ
description Abstract Introduction For women treated for cervical dysplasia at 60–64 years in Denmark, we reported the frequency of abnormalities before and after treatment of cervix uteri (most frequently performed as large loop excision of the cervical transformation zone, LLETZ) using population‐based real‐world data. Material and Methods We conducted a retrospective cohort study based on national data from the Danish Pathology Data Bank and identified women who underwent a LLETZ in 2010–2016 at the age of 60–64. Women were managed according to nationwide evidence‐based recommendations proposed by the Danish professional organizations. We retrieved information on all LLETZ specimens, cervical histology, cytology, and human papillomavirus (HPV) tests in the period of 2 years prior to the procedure to 2 years thereafter. We reported the frequencies of abnormalities before, at, or after the procedure. Results Of the 1014 women who had a LLETZ during the study period, 660 (65%) showed cervical intraepithelial neoplasia grade 1 or worse (CIN1+, including CIN1, CIN2, CIN3, cervical cancer, and CIN not otherwise specified) in their LLETZ specimen, with free resection margins in 255 (39%). Of the 1014 women, 551 (54%) had CIN2+ in a biopsy preceding the LLETZ and in 567 (56%) CIN2+ was found in their LLETZ specimen. In 37 (4%) women, the specimen showed cervical cancer; whereas in the pre‐LLETZ biopsies of these 37 women, cancer was detected in only 7 (1%). After LLETZ, 818 (81%) women underwent test‐of‐cure follow‐up which was positive in 406 women (40%). Furthermore, 408 (40%) women had new histological samples registered after LLETZ. These showed CIN2+ in 134 (13%) women, whereas a new cancer was diagnosed in 11 (1%) women. Conclusions Due to persistent abnormal tests after LLETZ, an extended follow‐up is still required for a large proportion of the women in this age group.
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spelling doaj-art-736c3b60e0db414087f4e0de480645652025-08-20T02:36:28ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122025-06-0110461112111910.1111/aogs.15111Outcomes associated with large loop excision of the cervical transformation zone in women 60–64 years of age: A population‐based register study from DenmarkJulie Laub Erdal0Reza Rafiolsadat Serizawa1Matejka Rebolj2Jeppe Bennekou Schroll3Department of Clinical Medicine University of Copenhagen Copenhagen DenmarkDepartment of Pathology Copenhagen University Hospital Amager and Hvidovre Hvidovre DenmarkCentre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health Queen Mary University of London London UKDepartment of Clinical Research, Centre for Evidence‐Based Medicine Odense and Cochrane Denmark University of Southern Denmark Odense DenmarkAbstract Introduction For women treated for cervical dysplasia at 60–64 years in Denmark, we reported the frequency of abnormalities before and after treatment of cervix uteri (most frequently performed as large loop excision of the cervical transformation zone, LLETZ) using population‐based real‐world data. Material and Methods We conducted a retrospective cohort study based on national data from the Danish Pathology Data Bank and identified women who underwent a LLETZ in 2010–2016 at the age of 60–64. Women were managed according to nationwide evidence‐based recommendations proposed by the Danish professional organizations. We retrieved information on all LLETZ specimens, cervical histology, cytology, and human papillomavirus (HPV) tests in the period of 2 years prior to the procedure to 2 years thereafter. We reported the frequencies of abnormalities before, at, or after the procedure. Results Of the 1014 women who had a LLETZ during the study period, 660 (65%) showed cervical intraepithelial neoplasia grade 1 or worse (CIN1+, including CIN1, CIN2, CIN3, cervical cancer, and CIN not otherwise specified) in their LLETZ specimen, with free resection margins in 255 (39%). Of the 1014 women, 551 (54%) had CIN2+ in a biopsy preceding the LLETZ and in 567 (56%) CIN2+ was found in their LLETZ specimen. In 37 (4%) women, the specimen showed cervical cancer; whereas in the pre‐LLETZ biopsies of these 37 women, cancer was detected in only 7 (1%). After LLETZ, 818 (81%) women underwent test‐of‐cure follow‐up which was positive in 406 women (40%). Furthermore, 408 (40%) women had new histological samples registered after LLETZ. These showed CIN2+ in 134 (13%) women, whereas a new cancer was diagnosed in 11 (1%) women. Conclusions Due to persistent abnormal tests after LLETZ, an extended follow‐up is still required for a large proportion of the women in this age group.https://doi.org/10.1111/aogs.15111cervical cancercervical intraepithelial neoplasiacytologyhuman papillomavirusloop electrosurgical excision procedurescreening
spellingShingle Julie Laub Erdal
Reza Rafiolsadat Serizawa
Matejka Rebolj
Jeppe Bennekou Schroll
Outcomes associated with large loop excision of the cervical transformation zone in women 60–64 years of age: A population‐based register study from Denmark
Acta Obstetricia et Gynecologica Scandinavica
cervical cancer
cervical intraepithelial neoplasia
cytology
human papillomavirus
loop electrosurgical excision procedure
screening
title Outcomes associated with large loop excision of the cervical transformation zone in women 60–64 years of age: A population‐based register study from Denmark
title_full Outcomes associated with large loop excision of the cervical transformation zone in women 60–64 years of age: A population‐based register study from Denmark
title_fullStr Outcomes associated with large loop excision of the cervical transformation zone in women 60–64 years of age: A population‐based register study from Denmark
title_full_unstemmed Outcomes associated with large loop excision of the cervical transformation zone in women 60–64 years of age: A population‐based register study from Denmark
title_short Outcomes associated with large loop excision of the cervical transformation zone in women 60–64 years of age: A population‐based register study from Denmark
title_sort outcomes associated with large loop excision of the cervical transformation zone in women 60 64 years of age a population based register study from denmark
topic cervical cancer
cervical intraepithelial neoplasia
cytology
human papillomavirus
loop electrosurgical excision procedure
screening
url https://doi.org/10.1111/aogs.15111
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