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The following is a summary of “Outcomes associated with large loop excision of the cervical transformation zone in women 60–64 years of age: A population-based register study from Denmark,” published in the April 2025 issue of Acta Obstetricia et Gynecologica Scandinavica by Erdal et al. 

Researchers conducted a retrospective study to report the frequency of cervical abnormalities before and after treatment, primarily with large loop excision of the cervical transformation zone (LLETZ), among women aged 60–64 years using population-based real-world data.  

They used national data to analyze women aged 60–64 who underwent LLETZ from 2010–2016. Management followed nationwide evidence-based guidelines from Danish professional organizations. Data on all LLETZ specimens, cervical histology, cytology, and human papillomavirus (HPV) tests were collected from 2 years before to 2 years after the procedure. Frequencies of abnormalities before, during, and after the procedure were reported.  

The results showed that among 1,014 women who underwent LLETZ, cervical intraepithelial neoplasia grade 1 or worse (CIN1+) was detected in 660 (65%) specimens, with free resection margins in 255 (39%). Preceding biopsies revealed CIN2+ in 551 (54%) women, while LLETZ specimens confirmed CIN2+ in 567 (56%). Cervical cancer was identified in 37 (4%) specimens, but only 7 (1%) had cancer detected in pre-LLETZ biopsies. Post-LLETZ, 818 (81%) underwent test-of-cure follow-up, with positive results in 406 (40%). New histological samples were registered for 408 (40%) women, revealing CIN2+ in 134 (13%) and new cervical cancer in 11 (1%).  

Investigators concluded that a significant number of women in this age group with persistent abnormal test results after LLETZ necessitated extended follow-up. 

Source: obgyn.onlinelibrary.wiley.com/doi/10.1111/aogs.15111