Smoking cessation counseling in women with genital intraepithelial neoplasia

Santoso, Joseph T.; Crigger, Mary; English, Emily; Wan, Jim Y.; Likes, Wendy

doi:10.1016/j.ygyno.2012.02.018

Cited by 10 publications

(7 citation statements)

References 29 publications

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“…However, since our results showed that cigarette smoking increased the risk of recurrence as well as progression to invasive disease, counseling women with genital IN to stop smoking seems advisable. Smoking cessation counseling is feasible in this patient population, and results on the effect of smoking cessation on recurrence and progression rate are eagerly awaited [29]. …”

Section: Discussionmentioning

confidence: 99%

Disease progression and recurrence in women treated for vulvovaginal intraepithelial neoplasia

et al. 2013

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ObjectiveThe malignant potential of intraepithelial neoplasia of the vulva and vagina after treatment is not well defined. Our objective was to examine risk factors for recurrence and invasive disease.MethodsFour hundred sixty-four women with biopsy proven high-grade intraepithelial neoplasia of the vulva and vagina were identified in the electronic databases of four colposcopy clinics. Inclusion criteria were a follow-up of more than one year, no history of invasive cancer and no invasive cancer within the first year after initial treatment. We investigated the potential factors associated with recurrence and progression using a logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsOf the 411 eligible patients, 123 patients (29.9%) recurred later than one year after initial treatment and 24 patients (5.8%) progressed to invasive disease. According to multivariate analyses, the risk factors associated with recurrence were multifocality (OR, 3.33; 95% CI, 2.02 to 5.51), immunosuppression (OR, 2.51; 95% CI, 1.09 to 5.81), excision as initial treatment (vs. laser evaporation; OR, 1.79; 95% CI, 1.11 to 2.91) and smoking (OR, 1.61; 95% CI, 1.02 to 2.55). Risk factors for progression to invasive disease were immunosuppression (OR, 4.00; 95% CI, 1.30 to 12.25), multifocality (OR, 3.05; 95% CI, 1.25 to 7.43) and smoking (OR, 2.97; 95% CI, 1.16 to 7.60), but not treatment modality.ConclusionLaser evaporation combined with extensive biopsy is at least as efficacious as initial treatment of intraepithelial neoplasia with excision. Smoking is a risk factor for both recurrence and progression to invasive disease. Hence, smoking cessation should be advised and maintaining a long follow-up period due to late relapses is necessary.

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Section: Discussionmentioning

confidence: 99%

Disease progression and recurrence in women treated for vulvovaginal intraepithelial neoplasia

et al. 2013

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“…HPV-related diseases of the lower genital tract are no different. 7,8 There are numerous other potential healthy lifestyle changes that may have an impact on the immune system; however, none are as well associated with cervical dysplasia and cancer as smoking. Women who smoke have been found to have a relative risk (RR) of 1.60 [95% confidence interval (CI), 1.48-1.73] of developing cervical cancer as compared with those who have never have smoked.…”

Section: Promoting Healthy Habitsmentioning

confidence: 99%

Secondary Prevention of Cervical Cancer Part 3

Guido

Lonky

Diedrich

2014

Clinical Obstetrics &Amp; Gynecology

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“…23 Whatever the modality used to treat women with this disease, recurrences may occur after 5 years in up to as many as 35% of patients. 24 Therefore, close and long-term follow-up is recommended in these patients.…”

Section: Treatment Of Preinvasive Diseasementioning

confidence: 99%