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January 6, 1993

Laser vs Cryotherapy for CIN and a LEEP of Faith

JAMA. 1993;269(1):46. doi:10.1001/jama.1993.03500010056024

To the Editor.  —Regarding the article written by Drs Huggins and Wentz1 on cervical intraepithelial neoplasia (CIN), I take strong exception to their statement that "most gynecologists will proceed with laser ablation of the cervix.. once a diagnosis of [CIN] is made, if the perimeters of the lesion can be visualized." We certainly hope that this statement is not true. Cryotherapy of ectocervical lesions has been the gold standard and mainstay therapy for many years. The development of laser ablation of these lesions has never been proven to be more effective in eradication of early CIN. The laser therapy contributed only to a monumental increase in the cost of treatment of this disease.Unfortunately, if an expensive carbon dioxide laser has been purchased, its cost must be recovered. If a physician had a choice between laser therapy and cryotherapy, both of which are equally effective, and the physician needed