Comparison of cryo- and carbon dioxide laser therapy for cervical intraepithelial neoplasia.

Two hundred ninety-four women with cervical intraepithelial neoplasia were treated once with either cryotherapy or laser vaporization. Treatment results were controlled for grade, size, and distribution of cervical intraepithelial neoplasia. Cervical intraepithelial neoplasia measuring less than 3 cm in diameter without extension into the endocervix had similar low failure rates (4 to 5%), regardless of histologic grade or instrument used. Carbon dioxide laser produced comparatively better results for lesions larger than 3 cm in diameter (92%) and those with up to 5 mm extension into the endocervical canal (89%), compared with 62 and 50%, respectively, with cryotherapy. Complications after cryo- and laser therapy were 0.6 and 7.4%, respectively, and included bleeding and pelvic inflammatory disease. Tailoring treatment modalities according to cervical intraepithelial neoplasia size and location rather than using a single treatment approach provides for the most cost-effective and therapeutically rewarding clinical practice.