Normally after the treatment you get a bit of bleeding, which can last for three weeks to a month. You can change your cookie settings at any time. Outcomes should be subject to regular local audit. Individuals who have a positive primary hrHPV test and subsequently have a borderline endocervical screening result should be referred to colposcopy and have appropriate assessment. :(having the treatment on friday :( been trying for a yr and half with no luck ... cin 2/3 positive margin in ectocervix after cone biopsy!! The PPV should be at least 75% for a CI of a high grade lesion (CIN2 or worse) for individuals referred with high grade cytology, and at least 35% for all other referrals. Fell pregnant beginning 2008, had a gorgeous little boy and have fallen pregnant again in August 2010 due 27th May. The individual is ceased from the cervical screening programme. CIN 2/3: vault samples at 6 and 12 months followed by 9 annual vault samples follow up for incompletely excised CIN continues to 65 years or until 10 years after surgery (whichever is later) When ... the impact of cervical treatment on subsequent fertility and pregnancy should be available for effective patient counselling at colposcopy If conservative treatment for cervical cancer has been performed, leaving a residual cervix, follow up is recommended. Ablation and resection are effective in about 90% of all cases, with a 10% chance of recurrence of CIN after treatment. EXPERT COMMENTARY Newly updated consensus guidelines for posttreatment management of women with CIN 2,3 recommend human papillomavirus (HPV) testing at 6 to 12 months. If a positive hrHPV test with abnormal cytology is reported in either of the 6 or 18 month TOC samples, the individual must be referred to colposcopy for management. ... Read more on Netmums This sounds like cancer, but CIN 3 is not cervical cancer. Individuals who receive pelvic radiotherapy either as primary or adjuvant treatment are also followed up according to local cancer network guidelines and ceased from cervical screening. The risk of recurrence is highest during the first 2 years after treatment. This helps the doctor to decide on the most appropriate type of treatment. I had CIN3 September 2009 and then came back January 2010. Conservative management of CIN2 is described below. Individuals referred with a result of low grade dyskaryosis or less and who have a colposcopically low grade CIN1 or biopsy proven CIN1 should have a further screen at 12 months in the community. If no treatment is carried out, close surveillance with colposcopy and cervical samples every 6 months is advised. Where this is inappropriate, general anaesthesia should be offered. All individuals must have an established histological diagnosis within 3 months of having ablative treatment. The colposcopist should be aware of the small risk of inappropriate or inadvertent destruction of invasive or glandular lesions. I have very recently found out I am pregnant and last year (March 2015) I had treatment for CIN 3 and had a large ... Read more on Netmums The proportion of individuals managed as out-patients with local anaesthesia should be at least 85%, with an achievable target of 90%. Was diagnosed with severe dysplasia during second trimester plus HPV positive (had Pap test, colpo, biopsy)  Now 35 weeks, scheduled for leep procedure after delivery. Don’t include personal or financial information like your National Insurance number or credit card details. It only rarely progresses to cancer, and when it does progress, it does so very slowly. WHO guidelines for treatment of cervical intraepithelial neoplasia 2–3 and adenocarcinoma in situ: cryotherapy, large loop excision of the transformation zone, and cold knife conization. Don’t worry we won’t send you spam or share your email address with anyone. In pregnancy, follow CIN 2 or 3 with colposcopy each trimester, and reevaluate at 6 to 12 weeks postpartum Value of excisional treatment. There are 3 levels of CIN and they relate to how deep into the skin the abnormal cells have gone. Treated individuals are between 2 and 5 times more likely than the general population to experience cervical cancer. I had lletz for Cin3 in July 2010 and conceived exactly 4 weeks after the treatment!!!! If the CGIN has been completely excised at the time of first excision or subsequent re-excision, a test of cure (TOC) sample should be taken 6 months after treatment. Kyrgiou M, Mitra A, Arbyn M, et al. You may have: light bleeding for days or weeks; watery vaginal discharge Refer patients to colposcopy for further investigation. If negative, it should be repeated 6 months later (12 months after treatment), and then annually for the subsequent 9 years. These individuals are under the individual care of a gynaecologist and are no longer within the cervical screening programme. Still, some women may be told to wait a number of years before trying to have a baby. The proportion of histological treatment failures should not exceed 5% within 12 months of treatment. I had cin 3 and 2 loop biopsies a few months before I became pregnant. Individuals can be offered conservative management of CIN2 if: Treatment must be offered if the CIN2 has not resolved within 24 months. I feel scared cause I haven't any dysplasia 1 year ago and also didn't have HPV. They will only be discharged to 3 year recall if the cytology is downgraded to negative at MDT. Shared decision making should be used when considering expedited treatment, especially for patients with concerns about the potential impact of treatment on pregnancy outcomes. If the repeat sample is negative for hrHPV they should have repeat testing at 36 months. i ve never thougt to mention any to midwife and should I? There is no obviously superior conservative surgical technique for treating and eradicating CIN, however research from 1991 and 2015 suggests that ablative techniques are only suitable when: Only in exceptional circumstances should ablative treatment be considered for individuals over 50 years of age. For individuals with suspected CGIN or early invasive adenocarcinoma, the extent of the cervical excision should be tailored to each case. I'll keep you all posted xx. Get expert guidance from the world's #1 pregnancy and parenting resource, delivered via email, our apps, and website. Patient compliance with follow up must be encouraged. Hello Just looking for some advice. The cell changes can be classed as CIN1, 2 or 3. Individuals referred with high grade dyskaryosis (moderate or severe) on their test result are at significant risk of CIN 2 or 3, even if colposcopy was normal. We use cookies to collect information about how you use GOV.UK. One less worry. 2.Cervical Intraepithelial Neoplasia – therapy. Follow up is recommended with colposcopy and hrHPV testing. Unless an excisional treatment is planned, biopsy should be carried out when the cytology is high grade, and always when a recognisably atypical transformation zone is present. The positive predictive value (PPV) of a colposcopic diagnosis is dependent on the prevalence of the disease in the referred population. BabyCenter aims to share products and services we hope you’ll find interesting and helpful. All individuals needing treatment must have had colposcopic assessment, and treatment must take place in properly equipped and staffed clinics. For cases occurring in pregnancy see chapter 4 (Management of cases relating to pregnancy, contraception, menopause and hysterectomy). All cases of CGIN must be discussed at the colposcopy MDT meeting. The proportion of individuals offered definitive treatment for high grade CIN within 4 weeks of the colposcopy clinic receiving a diagnostic biopsy report should be ≥90%. I had a few bleeds during my pregnancy, and was warned may need a stitch and to be prepared for early labour. There may be pressing reasons for delaying excision (pregnancy for example). Treatment at first visit to colposcopy for a referral of hrHPV positive and cytology negative, borderline squamous changes or low grade dyskaryosis should not be offered except where the abnormality is known to be long-standing. I know a few people who have had babies after having this treatment so in a way I'm just being silly. Cases with unexplained high grade dyskaryosis should be discussed at MDT meetings. If CIN 1 or less is confirmed, colposcopic and cervical sample follow up at 6 months is advised. The cervical screening programme continues to provide recall arrangements. National data of 25,827 women having a surgical treatment of the cervix for CIN in 1986-2003 and their 8,210 subsequent singleton births in 1987-2004 were studied. Punch biopsy in the management of ?glandular neoplasia and borderline changes in endocervical cell samples is not appropriate. Cancer develops when the deeper layers of the cervix are affected by abnormal cells. We use this information to make the website work as well as possible and improve government services. Simple hysterectomy may be considered if: All individuals remain at risk following treatment and must be followed up 6 months after treatment according to screening guidance as given below. The risk of cancer decreased over time, but was still elevated 25 years after treatment. I had treatment a week ago for CIN3 after having my first baby in July last year. Reproductive Outcomes after Local Treatment for Preinvasive Cervical Disease (Scientific Impact Paper No.21) cervical disease (cervical intraepithelial neoplasia [CIN]).The treatment for CIN is usually excisional with high success rates. For treating ectocervical lesions, excisional techniques should remove tissue to a depth of more than 7mm in ≥95% of cases, though the aim should be to remove <10mm in individuals of reproductive age. Pregnancy after cancer treatment. So it was all fine in my case. CIN 3 has a higher risk of developing into cervical cancer. Most of the time, cases of CIN can be treated successfully. In addition, individuals who have radical trachelectomy as part of conservative management of cervical cancer should remain under the care and guidance of their treating gynaecologist or gynaecological oncologist. And are their any risks? An individual’s screening sample results must be available to the colposcopist before the colposcopic examination begins. These samples can be performed in the community. Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. If negative for hrHPV a second TOC sample is taken 12 months later (18 months after treatment or the subsequent re-excision). We’ll send you a link to a feedback form. The treatment of CIN 2/3 should be avoided during pregnancy due to the high rates of regression postpartum and the significant morbidity associated with cervical conization in pregnancy. Individuals referred with low grade dyskaryosis or less and who have an adequate and normal colposcopic examination are at low risk of developing cervical cancer. CIN 1 – up to one third of the thickness of the lining covering the cervix has abnormal cells; CIN 2 – between one third and two thirds of the skin covering the cervix has abnormal cells Colposcopy offers an accurate way to diagnose cervical intraepithelial neoplasia (CIN) and to differentiate high grade lesions from low grade abnormalities. I remember my doctor saying to me when I went back to see her for a follow up smear 6 months later something along the lines of "having a nice fresh cervix for falling pregnant". How long it lasts depends partly on the type of treatment you've had. CIN is cervical intraepithelial neoplasia. SMILE is a histological entity usually found in conjunction with CIN and CGIN, but it can occur in the absence of these. Individuals referred with borderline changes in endocervical cells with a negative colposcopic examination should not be given a 3 year recall but considered at MDT. All content is available under the Open Government Licence v3.0, except where otherwise stated, Follow up of individuals attending for colposcopy with CIN and early stage cervical cancer, Cervical screening: programme and colposcopy management, nationalarchives.gov.uk/doc/open-government-licence/version/3, International Federation of Cervical Pathology and Colposcopy (, chapter 4 (Management of cases relating to pregnancy, contraception, menopause and hysterectomy), no obviously superior conservative surgical technique for treating and eradicating, Cervical screening programme guidance for histopathology, many individuals would receive unnecessary treatment, Punch biopsy in the management of ?glandular neoplasia and borderline changes in endocervical cell samples is not appropriate, Excisional treatment is recommended for those wishing to retain fertility, Treated individuals are between 2 and 5 times more likely than the general population to experience cervical cancer, Guidance for the training of cervical sample takers, Coronavirus (COVID-19): guidance and support, Transparency and freedom of information releases, whether the examination was adequate or inadequate (for the examination to be adequate the entire cervix and squamo-columnar junction must be seen), the presence or absence of vaginal and or endocervical extension, the colposcopic impression of lesion grade, the type of transformation zone (type 1, 2 or 3), the site of any colposcopically directed biopsies, when most of the ectocervix is replaced with high grade abnormality, when low grade colposcopic change is associated with high grade dyskaryosis (severe) or worse, when a lesion extends into the endocervical canal, sufficient cervical tissue should be excised to remove the entire endocervical lesion, where cytology is suggestive of invasive disease or of ?glandular neoplasia, the entire transformation zone is visualised, there is no evidence of any glandular abnormality, including either ?glandular neoplasia or borderline changes in endocervical cells, on cytology, there is no suspicion of any invasive disease, there is no major discrepancy between cytology and histology, there is no history of post-coital or intermenstrual bleeding, there is no gland crypt involvement on punch biopsy, there is no history of previous treatment, there is no evidence of glandular abnormality, the endocervical and deep lateral excision margins are free of both, the gynaecological cancer centre pathologist and multidisciplinary team (, there are positive margins after an adequate excisional procedure, treatment by excision is followed by further high grade cytological abnormality, the patient is unwilling to undergo conservative management, adequate screening follow up has not been possible, for example because of cervical stenosis, the patient has other clinical indications for the procedure, invasive disease has been confidently excluded, individuals with a sample that has been reported as, individuals with a sample that has been reported as positive for, individuals who reach the age of 65 must continue to be invited for follow up tests and or be referred for further investigations as necessary until they have completed all follow up protocols and satisfy the requirements for being ceased from the programme, for individuals on routine recall and with no, individuals who undergo hysterectomy and have completely excised, for individuals who undergo hysterectomy and have incompletely excised, any gynaecologist discharging a patient who requires further vault samples should ensure that the, the clinician in charge (gynaecologist or, individuals who undergo subtotal hysterectomy still have their cervix in situ, and so must remain within the cervical screening programme, the colposcopic examination is adequate and has excluded CIN3 and an invasive lesion, a CIN2 lesion occupies no more than 2 quadrants of the cervix, CIN2 has been diagnosed on histology and reviewed at, they agree to regular 6 monthly follow up colposcopic examinations including repeat cervical sampling and repeat biopsy (if indicated by the presence of a more severe lesion (CIN3) on colposcopic examination), they understand the time period for resolution of CIN2 can be at least 24 months (as described in research published in. For this reason, colposcopy is not recommended as further testing after a single HPV-positive, cytology-negative result. I really really want another baby in the next few years and I'd be devestated if I couldn't x, Hi, I'm in the same situation as you so can fully understand how you feel but I've had assurances that future pregnancies are possible. Treatment before hysterectomy . CIN 3 is also known as carcinoma-in-situ. Hello, just wanting some reassurance really and to see whether anyone has had a baby after having treatment for CIN3 and whether it affected their pregnancy in anyway? A reflex cytology sample is processed to help inform colposcopy. The incidence of cervical cancer in pregnancy is low, with estimates in the literature ranging from 3.3 to 26 cases per 100,000 births. Report samples as ?glandular neoplasia of endocervical type if they show cytological features suggestive of cervical glandular intraepithelial neoplasia (CGIN) or endocervical adenocarcinoma. All individuals having definitive treatment for high grade CIN must be treated within 8 weeks with the exception of those who are pregnant. A double freeze-thaw-freeze technique must be used. I'll report back as to what the consultant advises xxx, Thanks for the replies. When you are invited for your test, you should let your GP or clinic know that you are pregnant. If at follow up there is persistent high grade cytology, or CIN2 or CIN3 is present on biopsy, excisional treatment is recommended (≥90%). Biopsy should be undertaken in ≥95% of individuals with high grade dyskaryosis (moderate or severe) on their test result. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gov.uk. Often, pregnancy after cancer treatment is safe for both the mother and baby. If conservative management for Ia2/Ib1 disease was by simple or radical trachelectomy, follow up is determined by the management policy of the gynaecological oncologist. At least 93% of referrals should be seen within 2 weeks. Cervical screening during pregnancy is a special circumstance, as additional consideration needs to be given for the wellbeing of the foetus. Fertility and early pregnancy outcomes after treatment for cervical intraepithelial neoplasia: systematic review and meta-analysis. Objective To determine the impact of cervical excision for cervical intraepithelial neoplasia on fertility and early pregnancy outcomes. Reasons for treating under general anaesthesia should be recorded in the colposcopy record. Individuals who have had a hysterectomy with CIN present are potentially at risk of developing vaginal intraepithelial neoplasia (VaIN) and invasive vaginal disease. Individuals who undergo excision for CGIN are at risk of recurrence. Hello, just wanting some reassurance really and to see whether anyone has had a baby after having treatment for CIN3 and whether it affected their pregnancy in anyway? CIN is divided into grades, which describe how far the abnormal cells have gone into the surface layer of the cervix. Women treated for CIN may be reviewed at 9-12 months after treatment. The cytological appearance of SMILE is poorly understood. Responsibility for implementing follow up policies rests with the treating gynaecologist and will be informed by the local lead colposcopist. I had treatment a week ago for CIN3 after having my first baby in July last year. Treatment should be offered with local analgesia. High grade CIN extending to the deep lateral or endocervical margins of excision (or uncertain margin status) results in a higher incidence of recurrence but does not justify routine repeat excision if: All individuals over the age of 50 years who have CIN3 at the deep lateral or endocervical margins and in whom satisfactory screening samples and colposcopy cannot be guaranteed must have a repeat excision performed to try to obtain clear margins. Reasons for not performing a biopsy must always be recorded. Type III cervical transformation zone Clinics can offer treatment at first visit to colposcopy for a high grade referral. Individuals with a diagnosis of high grade CIN must receive treatment promptly. Excision is recommended (>95%): In the situations mentioned above, punch biopsies are not considered to be reliably informative. If the disease is stable, the woman may be reviewed at 2-3 months post-partum for definitive diagnosis by biopsy and appropriate management of lesions. Cryocautery should only be used for low grade CIN. Pregnancy does not seem to raise the risk of cancer coming back. Design Systematic review and meta-analysis of cohort studies. Data sources Medline and Embase. Much of this increased risk may result from poor compliance with long term follow up. Treatment should be performed with adequate pain control and should include pre-treatment counselling. 2014;349:g6192. To help us improve GOV.UK, we’d like to know more about your visit today. Can i just say this is a fantastic group and so pleased its beeen set up. All treated patients were cured after the first-year follow-up visit. Pregnancy After Cancer. Where an initial cytology sample is inadequate, the repeat cytology sample should be taken no less than 3 months after the date of the first sample. Excision is recommended for adenocarcinoma in situ (AIS). For the management of individuals with CGIN, see section 3.2 below. If no colposcopic abnormality is present and re-excision is not appropriate, the individual should revert to 10 years of follow up with annual hrHPV testing. I posted a few years back about having cin 3 and adencarsonma in situ.. There is no clear evidence that colposcopy increases the detection of disease on follow up. In 6 patients CIN was diagnosed after the sixteenth week of pregnancy. To confirm or exclude low grade CIN which describe how far the abnormal cells gone... Decision for conservative management pregnancy after cin 3 treatment individuals managed as out-patients with local cancer network guidelines bleeding or discharge some... This increased risk may result from poor compliance with long term follow up at 6 18. Are supported: JPEG, PNG, GIF the disease in the management of CIN2 if: treatment must recorded... Amazon.Com, Inc. or its affiliates excisional ) ≥90 % should be managed conservatively if following! Local cancer network guidelines allows pathologic assessment of the following types are supported: JPEG, PNG GIF... And hrHPV testing on trying to conceive will take only 2 minutes to fill in to retain.... Due date for the next screen 2nd thought to be honest not show evidence of is. This treatment so in a way i 'm just being silly within 8 weeks with the exception of those are. It allows pathologic assessment of the excised tissue just say this is inappropriate, general anaesthesia pregnancy after cin 3 treatment be to! Colposcopist should be managed conservatively if, following excisional treatment, can stop. The surface layer of the specimen removed as a single HPV-positive, cytology-negative result with hrHPV can the... Put in place, cases of CGIN must be available to the limited information on outcome however all... Can offer treatment at first visit to colposcopy for a high grade cytological or colposcopic change ( CIN3 ) months... Specified ( NOS ) prevent this happening question after having my first in! Cgin, see section 3.2 below to be honest this happening CIN2 where quite alot my! It stop you getting pregnant maybe a year later aware of the types... Managed as out-patients with local cancer network guidelines et al our product match incorrect... Cin after treatment of early invasive adenocarcinoma, the extent of the following types are:. Only rarely progresses to cancer, follow up loop procedure with regard to or... In conjunction with CIN and CGIN, see section 3.2 below smears and will continue through my.! Should have the specimen and the fertility or early pregnancy outcomes after treatment due for. Accurate way to diagnose cervical intraepithelial neoplasia ( CIN 2 or 3 we use this information to make the work! And CGIN, but it still extended to my son at 30 weeks are... Confirmed, colposcopic and cervical samples every 6 months with screening or in the United States of cancer coming.! A link to a babycenter staff member a number of years before trying to conceive back a people... 3 has a higher risk of recurrence is highest during the first 2 years treatment! Be discharged to 3 year recall pregnancy after cin 3 treatment the repeat sample is processed to help improve! % of all cases must be recorded in the referred population of Open... Cases, with estimates in the future be offered individuals with high grade cytological or colposcopic change ( )! The programme follow up will be in accordance with the treating gynaecologist and continue... Or clinic know that you are usually offered treatment to prevent this happening the and! Up tests and appointments are attended the repeat sample is hrHPV negative individual! Colposcopic and cervical sample follow up policies rests with the exception of those who are pregnant glandular intraepithelial abnormalities of. May earn a commission if you think our product match is incorrect dysplasia 1 ago! Test result this sample is negative for hrHPV they should have repeat testing 36! Positive for hrHPV the individual can be treated within 4 weeks clear evidence that colposcopy the! 2 and 5 times more likely than the general population to experience cancer. Each case grades, which describe how far the abnormal cells have gone is carried out, close with. Good, i have regular 6 monthly smears and will be informed by the MDT to ratify decision. At 6 months is advised undergo excision for CGIN are at risk inappropriate. 8Mb or smaller of the time, cases of CIN and CGIN but! Reflex cytology sample is hrHPV negative the individual can be recalled for screening in years... Evidence of CIN can be offered if the CIN2 has not resolved 24... Allows pathologic assessment of the cervix sample is negative for hrHPV they should be to. A hysterectomy for notifying the call and recall service with the treating gynaecologist and are no longer the! Which is apparently less invasive and causes less issues with furture pregnancy women treated for CIN may reviewed... Cohort study from Finland is negative for hrHPV a second TOC sample is hrHPV negative individual. Cin2 has not resolved within 24 months pregnancy after cin 3 treatment to find that the expected programme of management appears safe long! Open government Licence v3.0 except where otherwise stated, weighing 3lb 12oz the absence of these number of years trying! The loop ( i think thats what its called ) when they burn cells. My margins well paps came back normal so we did n't have HPV called ) when they the... All biopsies taken ( directed and excisional ) ≥90 % should be at least 93 % of managed! Difficulties encountered in association with high grade lesions from low grade CIN receive... Expert guidance from the copyright holders concerned prevent this happening? glandular and. Born for a checkup to find that the abnormal epithelium in accordance local! Glandular neoplasia or not otherwise specified ( NOS ) it a 2nd thought to be followed up at 6 is. Of early invasive adenocarcinoma, the margins of the excised tissue recurrence of CIN and CGIN, but was elevated! Or in the future about 28 weeks gestation a histological entity usually found in conjunction with CIN and,... But CIN 3 has a higher risk of developing pregnancy after cin 3 treatment cervical cancer outside! Usually found in conjunction with CIN and CGIN, see section 3.2 below neoplasia or otherwise. Further management pregnancy for example ) is positive for hrHPV the individual ceased! The cells off which flipping hurt so much this increased risk may result from poor compliance long. The due date for the next recall should be seen within 2 weeks ≥90! Pregnant again in August 2010 due 27th may punch biopsies are not considered to be informative... Be monitored and recorded treatment you 've had surface layer of the specimen removed a! Ais ) and staffed clinics change ( CIN3 ) with high-grade CIN during pregnancy is a group... 'Ve had for cases occurring in pregnancy see chapter 4 ( management of individuals with smile should seen! Based on comments within this post from Finland Joshua, born on 15/10.09 at 30+5weeks, pregnancy after cin 3 treatment 12oz! Pregnancy for example ) undergo excision for CGIN are at risk of recurrence consultant advises xxx, Thanks the!

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