Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jul 2:33:100608.
doi: 10.1016/j.gore.2020.100608. eCollection 2020 Aug.

Topical therapies for the treatment of cervical intraepithelial neoplasia (CIN) 2-3: A narrative review

Nerlyne Desravines  1 , Kate Miele  1 , Rebecca Carlson  2 , Carla Chibwesha  1   3 , Lisa Rahangdale  1   4
Affiliations
Review

Topical therapies for the treatment of cervical intraepithelial neoplasia (CIN) 2-3: A narrative review

Nerlyne Desravines et al. Gynecol Oncol Rep. .

Abstract

Current management of Cervical Intraepithelial Neoplasia (CIN), caused by high-risk human papillomavirus (hr-HPV), is based on surveillance and surgical therapy. Procedures carry potential risks such as preterm birth, and access remains limited throughout the world. However, there are no medical therapies recommended to promote the clearance of hr-HPV infection or CIN. Ultimately, even if less efficacious than excision procedures, medical therapies have the potential to decrease cervical cancer by eliminating barriers to treatment, such as access to treatment, or serving as an adjunct to surgical treatment in both high- and low-resource settings. This review describes current research on topical therapies with the potential for self-application for the treatment of HPV or CIN. Therapies included are immune-modulators, anti-proliferative medications, antivirals, hormones, and herbal/alternative therapies. Randomized trials of immune-modulating (imiquimod), anti-proliferative (5-fluorouracil), and anti-viral (cidofovir) therapies have had the most promising results. However, no option has sufficient clinical trial evidence to be recommended as treatment for CIN 2-3 and surgery remains the standard of care. The research described in this review serves as a guide for the development of future trials in the burgeoning arena of topical therapies for CIN 2-3.

Keywords: Cervical dysplasia; Cervical intraepithelial neoplasia (CIN) 2/3; Dysplasia treatment review; Excision alternatives; Medical management; Topical therapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
The PRISMA diagram for database search results of topical therapies for the treatment of Cervical Intraepithelial Neoplasia (CIN) 2/3.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ahn W.S., Yoo J., Huh S. Protective effects of green tea extracts (polyphenon E and EGCG) on human cervical lesions. Eur. J. Cancer Prev. 2003;12:383–390. - PubMed
    1. Ashrafian L, Sukhikh G, Kiselev V, et al. Double-blind randomized placebo-controlled multicenter clinical trial (phase IIa) on diindolymethane’s efficacy and safety in the treatment of CIN: implications for cervical cancer prevention. EPMA J. 2015;6:doi: 10.1186/s13167-13015-10048-13169. - PMC - PubMed
    1. Ashton H., Beveridge G.W., Stevenson C.J. Topical treatment of skin tumours with 5-fluorouracil. Br. J. Dermatol. 1970;82(2):207–209. - PubMed
    1. Barten G. Local treatment of cervical intraepithelial neoplasia using 5 percent 5-fluoruracil cream. Zentralbl. Gynakol. 1987;109:1510–1516. - PubMed
    1. Batman G., Hampson L., Hampson I.N. Lessons from repurposing HIV drugs: a prospective novel strategy for drug design. Future Virology. 2011;6:1021–1023.

LinkOut - more resources