A Prospective Study of Biopsy-Confirmed Cervical Intraepithelial Neoplasia Grade 1: Colposcopic, Cytological, and Virological Risk Factors for Progression

Greenberg, Mitchell; Reid, Richard; Schiffman, Mark; Campion, Michael J.; Precop, Sheryl L.; Berman, Nancy R.; Zemlo, Tamara; Husain, Mujtaba; Herman, Gilbert E.; Omato, Katherine H.; Lörincz, Attila T.

doi:10.1046/j.1526-0976.1999.08094.x

Cited by 6 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This resulted in 125 studies being excluded. The remaining 89 studies were included for meta-analysis, of which 63 studies with CIN 1 patients, 8–70 42 studies with CIN 2 patients, 11,26,27,35–37,39,41–44,50,52,53,57,69–95 and 7 studies with CIN 3 patients 3,26,41,72,81,83,88 . The characteristics and the follow-up protocol of the included studies are summarized in Supplementary Tables 1–3, http://links.lww.com/LGT/A239, http://links.lww.com/LGT/A240, http://links.lww.com/LGT/A241.…”

Section: Resultsmentioning

confidence: 99%

The Natural History of Cervical Intraepithelial Neoplasia Grades 1, 2, and 3: A Systematic Review and Meta-analysis

Loopik

Bentley

Eijgenraam

et al. 2021

J Low Genit Tract Dis

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

The Natural History of Cervical Intraepithelial Neoplasia Grades 1, 2, and 3: A Systematic Review and Meta-analysis

Loopik

Bentley

Eijgenraam

et al. 2021

J Low Genit Tract Dis

View full text Add to dashboard Cite

show abstract

“…In the past, treatment of persistent CIN1 was believed to prevent progression to CIN2 and CIN3. However, subsequent research showed that CIN1 can be caused by many genotypes of HPV, that repeated CIN1 is not necessarily indicative of viral persistence, and that only 8% progress to CIN3 over 2 years, making treatment unnecessary in most patients …”

Section: Discussionmentioning

confidence: 99%

Cervical Cancer Screening

Perkins

Wentzensen

Guido

et al. 2023

JAMA

128

View full text Add to dashboard Cite

ImportanceEach year in the US, approximately 100 000 people are treated for cervical precancer, 14 000 people are diagnosed with cervical cancer, and 4000 die of cervical cancer.ObservationsEssentially all cervical cancers worldwide are caused by persistent infections with one of 13 carcinogenic human papillomavirus (HPV) genotypes: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68. HPV vaccination at ages 9 through 12 years will likely prevent more than 90% of cervical precancers and cancers. In people with a cervix aged 21 through 65 years, cervical cancer is prevented by screening for and treating cervical precancer, defined as high-grade squamous intraepithelial lesions of the cervix. High-grade lesions can progress to cervical cancer if not treated. Cervicovaginal HPV testing is 90% sensitive for detecting precancer. In the general population, the risk of precancer is less than 0.15% over 5 years following a negative HPV test result. Among people with a positive HPV test result, a combination of HPV genotyping and cervical cytology (Papanicolaou testing) can identify the risk of precancer. For people with current precancer risks of less than 4%, repeat HPV testing is recommended in 1, 3, or 5 years depending on 5-year precancer risk. For people with current precancer risks of 4% through 24%, such as those with low-grade cytology test results (atypical squamous cells of undetermined significance [ASC-US] or low-grade squamous intraepithelial lesion [LSIL]) and a positive HPV test of unknown duration, colposcopy is recommended. For patients with precancer risks of less than 25% (eg, cervical intraepithelial neoplasia grade 1 [CIN1] or histologic LSIL), treatment-related adverse effects, including possible association with preterm labor, can be reduced by repeating colposcopy to monitor for precancer and avoiding excisional treatment. For patients with current precancer risks of 25% through 59% (eg, high-grade cytology results of ASC cannot exclude high-grade lesion [ASC-H] or high-grade squamous intraepithelial lesion [HSIL] with positive HPV test results), management consists of colposcopy with biopsy or excisional treatment. For those with current precancer risks of 60% or more, such as patients with HPV-16–positive HSIL, proceeding directly to excisional treatment is preferred, but performing a colposcopy first to confirm the need for excisional treatment is acceptable. Clinical decision support tools can facilitate correct management.Conclusions and RelevanceApproximately 100 000 people are treated for cervical precancer each year in the US to prevent cervical cancer. People with a cervix should be screened with HPV testing, and if HPV-positive, genotyping and cytology testing should be performed to assess the risk of cervical precancer and determine the need for colposcopy or treatment. HPV vaccination in adolescence will likely prevent more than 90% of cervical precancers and cancers.

show abstract

“…Moreover, it was suggested that cervical inflammation may be a cofactor for high-grade cervical lesions in women infected with oncogenic HPV [15]. Similarly, two studies reported that genital infections leading to chronic inflammation increased the risk of developing CIN [42,43]. In all these studies, it was evident that inflammation was strongly related with CIN, a precursor lesion for development of cervical cancer.…”

Section: Discussionmentioning

confidence: 99%

“…In order to explore the influence of different degrees of inflammation in the ASC, LSIL and HSIL, we analyzed the percentage of mild inflammation, moderate inflammation and severe inflammation in control group, ASC group, LSIL group and HSIL group. The result indicated that in the control group and the ASC group, the percentages of severe inflammation (2%, 19.46%) were lower than those with mild (42.5%, 43.8%) and moderate inflammation(15.8%, 25.58%). While, in the LSIL and HSIL groups, the percentages of severe inflammation (43.35%, 50.22%) were higher than mild(20.80%, 13.68%)and…”

Section: The Correlation Between Cervical Inflammation Degrees and Cymentioning

confidence: 90%

Severe Inflammation Indicates High Risk of HSIL: from a Cross-Sectional Study

Lin¹,

Long²,

Chen³

et al. 2019

Preprint

View full text Add to dashboard Cite

Inflammation has been reported as a facilitator in cervical oncogenesis, but the correlation between inflammation and cytology abnormality including Cervical Intraepithelial Neoplasia (CIN) remains uncertain. The aim of this study was to investigate the correlation between them with ThinPrep cytological test (TCT) as a screening tool for cervical cancer and CIN, which can identify abnormal morphology of cervical mucosa epithelium and inflammation degrees. A retrospective analysis of clinical data from 48101 women undergoing TCT in the affiliated hospitals of Sun Yat-Sen University (SYSU) revealed that among the 8.87% (4102 cases) total positive rate of ASC, LSIL and HSIL, 67.7% (2777/4102) of TCT positive samples had inflammatory infection. The rate of severe inflammation was significantly higher in cytological abnormality group than the control group (15.1% vs. 2%, P=0.000). Our results showed that severe inflammation significantly increased incidence of cytological abnormality by 12.59 times and elevated the risk of HSIL by 756.47 times. In conclusion, severe inflammation increased the risk of cytological abnormality, and should be viewed as an important risk of HISL. These results of our study remind clinicians to be more watchful for women with severe cervical inflammation in TCT reports for earlier prevention of the HSIL.

show abstract

A Prospective Study of Biopsy-Confirmed Cervical Intraepithelial Neoplasia Grade 1: Colposcopic, Cytological, and Virological Risk Factors for Progression

Cited by 6 publications

References 16 publications

The Natural History of Cervical Intraepithelial Neoplasia Grades 1, 2, and 3: A Systematic Review and Meta-analysis

The Natural History of Cervical Intraepithelial Neoplasia Grades 1, 2, and 3: A Systematic Review and Meta-analysis

Cervical Cancer Screening

Severe Inflammation Indicates High Risk of HSIL: from a Cross-Sectional Study

Contact Info

Product

Resources

About