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14 November 2019

Thermal ablation versus cryotherapy or loop excision to treat women positive for cervical precancer on visual inspection with acetic acid test: pilot phase of a randomised controlled trial

Early results of a new pilot study conducted by researchers from the International Agency for Research on Cancer (IARC) and partners suggest that an innovative device provides an effective method to treat cervical pre-cancers in low- and middle-income countries. The results were published today in The Lancet Oncology.

The pilot study, in Lusaka, Zambia, compared three different treatments in women who were eligible for ablative therapy for cervical pre-cancer: cryotherapy, the ablative method currently recommended by the World Health Organization (WHO) for screen-and-treat programmes; large loop excision of the transformation zone (LLETZ), the standard treatment in most high-income countries; and thermal ablation (the method under trial), which functions by heating the epithelium at the transformation zone to 100 °C.

Cryotherapy presents difficulties because it requires a supply of refrigerant gas and has a relatively long treatment duration and a relatively high cost. Thermal ablation uses a lightweight, portable, battery-operated device and has a short treatment duration. IARC scientists provided valuable technical input in the design and development of the new thermal ablation device.

The pilot study was funded by the United States National Institutes of Health and carried out in collaboration with Professor Groesbeck Parham, Dr Leeya Pinder, and their team in Lusaka. The results suggest that thermal ablation is as safe and as effective as cryotherapy, without the practical disadvantages of cryotherapy. Recruitment for the full trial is under way, and recruitment and follow-up are expected to be completed within 2 years. The results of the pilot study provide valuable evidence to inform the recently published WHO recommendation for using thermal ablation to treat cervical pre-cancers.

Pinder LF, Parham GP, Basu P, Muwonge R, Lucas E, Nyambe N, et al.
Thermal ablation versus cryotherapy or loop excision to treat women positive for cervical precancer on visual inspection with acetic acid test: pilot phase of a randomised controlled trial
Lancet Oncol, Published online 13 November 2019;
https://doi.org/10.1016/S1470-2045(19)30635-7

Read the article
Watch video of Dr Partha Basu describing the trial and the results
Watch video of Dr Walter Prendiville describing why the device was developed and the advantages it offers
Read commentary
Read the WHO guidelines for the use of thermal ablation for cervical pre-cancer lesions

Publication status

Published in section: IARC News

Publication date: 14 November, 2019, 0:03

Direct link: https://www.iarc.fr/news-events/thermal-ablation-versus-cryotherapy-or-loop-excision-to-treat-women-positive-on-visual-inspection-with-acetic-acid-test-pilot-phase-of-a-randomised-controlled-trial/

© Copyright International Agency on Research for Cancer 2019
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