Comparative Safety and Efficacy of Thermal Ablation Versus Cryotherapy for Treating Cervical Precancerous Lesions on Visual Inspection with Acetic Acid

Abstract Introduction: Cervical cancer remains a significant global health challenge, particularly in low and middle-income countries (LMICs), where delayed diagnoses often result in advanced-stage disease. To alleviate this, effective and accessible screening and treatment methods are crucial, enabling early detection and intervention to reduce cervical cancer related morbidity and mortality. Objectives: This study aims to evaluate the efficacy and safety of thermal ablation versus cryotherapy for treating cervical precancerous lesions in low-resource settings. Methods: This study enrolled 60 women with cervical precancerous lesions confirmed by visual inspection with acetic acid (VIA test). Participants were randomly assigned to receive either thermal ablation (n=30) or cryotherapy (n=30). Safety outcomes, including adverse events and side effects, were assessed during and after treatment. Efficacy outcomes, including complete regression of lesions, were evaluated at 12 weeks post-treatment using VIA. Statistical analysis was performed using Chi-square tests for categorical variables and independent sample t-tests for continuous variables, with a significance level set at p ≤ 0.05. Results: The mean age of participants was comparable between groups (Group A: 38.43 ± 6.82 years; Group B: 37.27 ± 7.76 years). The majority of patients in both groups (68.33% thermal ablation, 66.6% cryotherapy) reported no adverse events during treatment. Anxiety was most common side effect (30% thermal ablation, 33.3% cryotherapy). Pain levels and post-procedural complications were similar, with high patient satisfaction rates reported (90% cryotherapy; 96.7% in thermal ablation). Complete regression of lesions occurred in 96.7% of thermal ablation and 93.3% of cryotherapy at 12 weeks post-treatment with high satisfaction. Conclusion: Thermal ablation is a safe and effective alternative to cryotherapy, with comparable efficacy and high patient satisfaction. Its portability and reduced operational costs make it particularly suitable for resource-limited settings, supporting efforts to eliminate cervical cancer through single-visit screening and treatment strategies.