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Histology of Loop Electrosurgical Excision Procedures Performed on Women Younger Than 21 Years and 65 Years or Older

Cejtin, Helen E. MD; Malapati, Radha MD; Chaparala, Sushma MD

Journal of Lower Genital Tract Disease: April 2011 - Volume 15 - Issue 2 - p 93-97
doi: 10.1097/LGT.0b013e3181f2d4e8
Original Articles

Objective. To examine the prevalence and histology of loop electrosurgical excision procedures (LEEPs) done on women who are outside the age limits of the updated guidelines for cervical cytologic screening.

Materials and Methods. A database of all LEEPs performed between October 2004 and November 2009 was created. All data on age, human immunodeficiency virus status, cytology and histology before the procedure, and histology of the LEEP specimen were collected.

Results. There were 939 LEEPs performed during the study period, and data on 64 cases were excluded because of inadequate information. Fifty-four LEEPs were performed on women who were either younger than 21 years and those 65 years or older. All LEEPs were performed under traditionally accepted indications, except for 1 LEEP, which was excluded. None of the women gave a history of human immunodeficiency virus infection, and none of the older women had a history of abnormal cervical cytologic result before the index case. Of the procedures performed on the adolescents, 24 demonstrated high-grade lesions on LEEP (51.1%). Of the 6 procedures performed on older women, 4 LEEP specimens demonstrated high-grade lesions (66.7%). There were no cancers.

Conclusions. We treated many women with LEEP excision who would not have been screened using current 2009 guidelines. Most of these women had high-grade lesions. The new guidelines may not be applicable to all population groups.

Adolescent and older women have a high prevalence of high grade CIN on LEEP specimens.

Department of Obstetrics and Gynecology, John H. Stroger Jr, Hospital of Cook County, Chicago, IL

Correspondence to: Helen E. Cejtin, MD, 1969 W Ogden Ave, Chicago, IL 60612. E-mail:

©2011The American Society for Colposcopy and Cervical Pathology