Regression and Progression Predictors of CIN2 in Women Younger Than 25 Years.

J Low Genit Tract Dis

1Radboud University, Nijmegen, The Netherlands; 2Research Methods Unit, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; 3Department of Obstetrics and Gynecology, Radboudumc, Nijmegen, The Netherlands; and 4Department of Obstetrics and Gynecology, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.

Published: July 2016

Objective: The purpose of this study was to review the management and outcome of cervical intraepithelial neoplasia 2 (CIN2) in women younger than 25 years.

Methods: A retrospective review was performed, investigating women younger than 25 years at the time of diagnosis with biopsy-proven CIN2 between January 1, 2010, and December 31, 2014, who were seen in the colposcopy clinic at the Queen Elizabeth II Hospital in Halifax, Nova Scotia, Canada. The regression, persistence, and progression rate of CIN2 in conservative managed women were evaluated, and potential risk factors were examined. Colposcopy, cytologic, and histopathologic findings were compared with women with immediate treatment (<6 months).

Results: Of the 319 women included in the study, 108 women received immediate treatment, and 211 women were managed conservatively; of these, 144 women remained untreated, and 67 women received treatment 6 months or greater. From the women managed conservatively, 150 women (71.1%) showed regression, 26 women (12.3%) had persistent disease, and 35 women (16.6%) progressed, with a median follow-up of 15.1 months. None of the women included in the study progressed to invasive cancer. The hazard ratio for time to progression was 2.40 for women who smoked (p = 0.006).

Conclusions: A conservative approach of CIN2 is the preferred management option for women younger than 25 years. Smoking was identified as a risk factor for progression.

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http://dx.doi.org/10.1097/LGT.0000000000000215DOI Listing

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