Till Örebro universitet

IntroductionPremalignant changes in the cervix are common and can cause invasive cervical cancer withtime if not treated. Most are found in the population-based screening program offered inSweden. Persistent HPV infection in the cervix is required for these lesions to arise.Conization of the cervix is an accustomed treatment where a cone shaped part of the cervix,containing the lesion, is removed. If the conization is not radical residual disease remains,also recurrent disease is not uncommon.AimThe aim with this study was to investigate whether age at conization affects treatmentoutcome regarding HPV clearance and margin status.MethodsIn Stockholm 532 women were treated with conization, the surgery material was examinedregarding histological grading and radicality. Age at treatment was noted. At follow-up visitsa cytology cell sample and HPV-test were collected and cervical biopsies were performed onchosen women. All 532 women participated the first follow-up visit 6 months after surgeryand 114 women who were cytology and/or HPV positive at the first visit, were called to thesecond follow-up visit 12 months after surgery.ResultsA pattern of older women having uncleared hrHPV infections as well as non-radicalconization was noted. Women with treatment failure were 5.8 years (95% CI 1.2-10.6) olderthan cured women, shown with statistical significance.ConclusionWomen with treatment failure, recurrent and/or residual precarcinous changes of the cervix,were older than cured women.