Open AccessSpontaneous regression of CIN 2 in women aged 18–24 years: a retrospective study of a state‐wide population in Western Australia
Author(s) -
Munro Aime,
Powell Rhys G.,
A. Cohen Paul,
Bowen Shirley,
Spilsbury Katrina,
O'Leary Peter,
Semmens James B.,
Codde Jim,
Williams Vincent,
Steel Nerida,
Leung Yee
Publication year - 2016
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12835
Subject(s) - medicine , retrospective cohort study , dysplasia , cohort , biopsy , population , cervical intraepithelial neoplasia , logistic regression , hysterectomy , gynecology , surgery , cancer , cervical cancer , environmental health
CIN 2 has a high rate of spontaneous regression in young women and may be managed conservatively in appropriately selected patients. This study aimed to investigate health outcomes in women aged 18–24 years with biopsy‐confirmed CIN 2. Material and methods A retrospective cohort study of Western Australian women aged 18–24 years diagnosed with CIN 2 on cervical biopsy from 1 January 2001 to 31 December 2010. Women who had not received treatment at ≥4 months following CIN 2 diagnosis were classified as managed ‘conservatively’. Subsequent cervical cytology and/or biopsy test results were used to report lesion regression (absence of dysplasia or an epithelial lesion of lower grade than CIN 2) and disease persistence ( CIN 2, CIN 3 or ACIS ). Results Follow‐up data were available for 2417 women of whom 924 (38.2%) were ‘conservatively’ managed. In all, 152 (16.4%) conservatively managed women had a lesion more severe than CIN 2 detected within 24 months of initial diagnosis, of which 144 were CIN 3 and eight were ACIS . There was no statistically significant association between rates of regression and patient age, Socio‐economic Indexes for Areas or Accessibility/Remoteness Index of Australia indices. The 2‐year regression rate for CIN 2 was estimated to be 59.5% (95% CI 0.5–0.6) in this cohort of women. Conclusion In conservatively managed young women with CIN 2 there was a high rate of spontaneous disease regression. Thus, excisional or ablative treatments may be avoided in selected patients who receive appropriate counseling and who are able to comply with more intensive and prolonged follow‐up requirements.