Our results should be interpreted with caution because the database had important limitations. It seems likely that unpublished studies were performed with fewer resources and under lower standards of quality assurance. Therefore, even if the negative results may have remained unpublished, there is also a possibility that the results presented in our review underestimate the true negative results of cryotherapy and leep performed under routine conditions in the peripheral settings deprived of resources. Our review does not provide evidence that cryotherapy and leep for cervical lesions in low- and middle-income are associated with side effects, more frequent or more severe than in resource-rich settings. Our review indicates, however, that the current data are insufficient to fully inform decisions on protocols for the Pap test in women and women of childbearing age with HIV.
Finally, alternatives to cryotherapy and leep are needed. Sibylle kristensen, jeffrey its silt and Mulindi h mwanahamuntu also contributed to this work. We thank catherine hogan smith for his expert help in the electronic search and casey w. Frew for his contribution to the effort to recover the publishing and data abstraction. The project described was supported by several r21ca124336 price of the National Cancer Institute.
The content is solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. Features cryotherapy studies, and cryotherapy studies against leep, included in the review. Characteristics of LEEP only studies included in the review. The authors declare they have no conflict of interest.
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Researchers From Cyprus Design Early Cancer Screening Device – BTF