Every year, over 900 women in the Netherlands are diagnosed with cervical cancer. Approximately one-third of these patients are under 40 years old and may wish to carry children later. Almost all cases of cervical cancer are caused by the HPV virus. If the tumor is detected at an early stage, fertility-sparing treatment is often an option. No research has been done into the optimal post-treatment follow-up, however. Current follow-up procedures involve multiple Pap smears over a period of time, which leads to high health care costs and periods of uncertainty and stress for the patients.
To explore whether there are potential improvements for this follow-up process, researchers analyzed data from over 1400 patients who underwent fertility-sparing treatment between 2000 and 2020. About 75% of patients who have had co-testing done (a Pap smear that reveals HPV as well as abnormal cells) at 6 and 12 months after treatment showed no high-risk abnormalities indicating tumor recurrence. This data suggests that patients with two negative tests after treatment may benefit from follow-up appointments at 12-month intervals instead of, for example, every six months.
Gynecologist Nienke van Trommel emphasizes the importance of these findings: “This research provides concrete insights into follow-up care after fertility-sparing surgery. We now need to prospectively determine how we can keep follow-up care safe and cost-effective based on these results.”