What Are the Chances of Getting Cervical Cancer After a LEEP (Loop Electrosurgical Excision Procedure)?

Does a LEEP increase your risk for cervical cancer?

On its own, a LEEP doesn’t increase your risk for cervical cancer. The goal of a LEEP is to reduce your risk of cervical cancer by removing precancerous cells.

However, a small number of people who have had a LEEP have persistence or recurrence of CIN, which can potentially develop into cervical cancer later on.

Risk factors for CIN following a LEEP

Generally speaking, researchers have found that having positive margins and having a current human papillomavirus (HPV) infection play a big role in CIN persistence or recurrence after LEEP.

Positive margins

A margin is a small area of neighboring healthy cells that is also removed during a LEEP. A doctor looks at the margin to see whether abnormal cells are present. Positive margins can indicate that not all the abnormal cells were removed.

A 2020 study found that, compared with people who underwent a laser conization (another treatment for CIN), those who had a LEEP had a higher risk of positive margins after their procedure.

HPV

HPV is the main risk factor for cervical cancer. More than 90% of cervical cancers are caused by HPV, according to the Centers for Disease Control and Prevention (CDC).

In a 2024 analysis of 12 studies, researchers found that when margins were negative, the recurrence rate of CIN was very low (0.5%). However, having detectable HPV, even if margins were negative, increased the recurrence rate to 18%.

Other factors

Researchers have also identified other factors that may increase the risk of recurrent CIN after LEEP. These include:

• a higher grade of CIN, which means the cells look more abnormal under a microscope
• smoking
• a suppressed immune system

What are the other potential risks of a LEEP?

Overall, a LEEP is safe and has a low risk of complications. Possible short-term risks after a LEEP include:

• heavy bleeding
• pelvic infections
• a reaction to the anesthesia used during the procedure

It’s also possible to have an increased risk of future pregnancy complications if you’ve had a LEEP. While research is conflicting, some researchers have found that these complications can include:

• preterm delivery due to cervical insufficiency
• premature rupture of fetal membranes
• low birth weight
• cervical stenosis

How effective is a LEEP for removing precancerous cells in the cervix?

LEEP is generally quite effective at removing precancerous cells from the cervix. The authors of one 2021 study note that in past research, LEEP has been found to have a CIN cure rate ranging from 73% to 99%.

In addition to LEEP, there are two other procedures that healthcare professionals can use to treat precancerous changes in the cervix:

• Ablation: This procedure involves using extreme cold (cryosurgery) or a laser to destroy abnormal cells.
• Conization: Also known as a cone biopsy, this procedure involves removing a cone-shaped area of abnormal tissue. It can be done using a blade (cold knife conization) or a laser (laser conization).

What can you do to improve recovery after a LEEP?

If you’ve recently had a LEEP, you can take the following steps to help improve your recovery:

• Use over-the-counter medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce discomfort or pain.
• Wear pads to help manage vaginal discharge that can happen after a LEEP.
• Don’t place anything into your vagina until your doctor tells you it’s safe to do so. In addition to avoiding vaginal sex during this time, you should avoid:
  • using tampons
  • douching
  • using sex toys
• Avoid strenuous activities during your recovery period, as directed by your doctor.
• Avoid swimming or soaking in a hot tub or bathtub.

What can you do to lower your risk of cervical cancer after a LEEP?

You can lower your risk of cervical cancer after a LEEP by:

• quitting smoking if you currently smoke
• taking steps to reduce your risk of HPV, such as by:
  • getting the HPV vaccine
  • using condoms or another barrier method during sex
  • limiting your number of sexual partners

If you’ve had a LEEP, your doctor will want to follow up with you regularly to check for CIN persistence or recurrence and for cervical cancer. This follow-up may involve pelvic exams, Pap smears, and HPV tests.

It’s also important to see your doctor if you develop symptoms of cervical cancer, which may include:

• abnormal vaginal bleeding, such as:
  • bleeding after menopause
  • bleeding between periods
  • bleeding after sex
  • menstrual periods that are longer, heavier, or more irregular than is typical for you
• abnormal vaginal discharge that may contain blood
• pelvic pain or pain during sex

Takeaway

LEEP is typically very effective at removing precancerous cells from your cervix, helping prevent cervical cancer. However, a small number of people may experience persistence or recurrence of their CIN or develop cervical cancer after a LEEP.

Having positive margins, HPV, or both after your LEEP procedure can contribute to CIN persistence or recurrence after the procedure.

If you’ve had a LEEP, be sure to follow the recovery instructions your doctor provides and to have regular follow-ups. Quitting smoking and taking steps to prevent HPV can also help reduce your risk of developing cervical cancer.