Efficacy of thermal ablation among women with cervical intraepithelial neoplasia grade 1 and high‐risk human papillomavirus genotypes: The first prospective study in Vietnam
Abstract
Objective
This study aimed to investigate the efficacy of thermal ablation (TA) for treating cervical intraepithelial neoplasia grade 1 (CIN 1) among women with positive high‐risk human papillomavirus (hr‐HPV).
Methods
This prospective study was conducted at Tu Du Hospital, Vietnam between August 2023 and February 2025. The study enrolled all the women aged greater than 30 years with CIN 1 and positive hr‐HPV test treated with TA. The primary outcome included evaluation of healed lesion on cytology, colposcopy combined with visual inspection of the cervix with acetic acid (VIA) and Lugol's iodine testing as well as HPV clearance rate. The secondary outcome included patient's satisfaction and undesirable effects during the treatment and follow‐up visits.
Results
Among 66 women eligible for inclusion in the study, the clearance rate of all hr‐HPV genotypes at 3 and 6 months was 62.1% and 84.6%, respectively. The clearance rates of HPV 16 and HPV 18 after undergoing TA treatment was highly achieved at 88.8% and 85.7%, respectively. Overall, the clearance rate of HPV 16, 12 other hr‐HPV genotypes, overall hr‐HPV genotypes and normal colposcopic findings were significantly improved following treatment compared to before treatment ( P < 0.05). After 6 months, the overall cure rate of thermal ablation was observed at 60.6% (40/66 cases). The most common side effects included vaginal heat (43.1%), abdominal pain (34.8%), and vaginal pain (27.9%). On monitoring, patient's satisfaction was highly achieved at 93.9% on day 0 post‐treatment and for 95.5% at 3‐month control visit. No adverse effects as well as requirement of repeated ablation were reported.
Conclusions
Thermal ablation is an effective, safe, and well‐tolerated treatment for women with CIN 1 and positive hr‐HPV genotypes. This reliable modality shows a promising option for cervical cancer prevention in low‐resource settings. Further studies are required to strengthen these findings in different populations.