The introduction of systematic call and recall screening programmes in the UK has resulted in a profound decrease in the incidence and mortality of invasive cervical cancer. The purpose of the screening programme is to identify preinvasive cervical disease (cervical intraepithelial neoplasia [CIN]). The treatment for CIN is usually excisional with high success rates.
When considering the impact of treatment on fertility, the influence of the type and radicality of the treatment on the chances of recurrence or the risk of future invasive disease should be carefully balanced. As the mean age of women undergoing treatment for preinvasive cervical disease is similar to the age of women having their first child, the evidence for the impact of cervical treatment on subsequent fertility and pregnancy should be available for effective patient counselling at colposcopy and antenatal clinics.
Clinical practice varies across Europe and beyond, although most countries have moved to less aggressive techniques. This Scientific Impact Paper attempts to present the current evidence and future research required, with particular focus on UK practice.
Declaration of interests (guideline developers)
Dr M Kyrgiou MRCOG, London: Dr Kyrgiou’s research is funded by public bodies and charities in the UK, for example Imperial College Healthcare Charity Fellowship. She has received honoraria and travel expenses for advisory boards (consultancies), lectures at scientific meetings and fees for expert testimony.
Dr PL Martin-Hirsch FRCOG, Preston: None declared.
Professor EA Paraskevaidis University Hospital of Ioannina, Greece: None declared.
Professor PR Bennett FRCOG, London: None declared.