Influence of age on histologic outcome of cervical intraepithelial neoplasia during observational management: results from large cohort, systematic review, meta-analysis

Abstract

Aim of this study was to investigate the histologic outcome of cervical intraepithelial neoplasia (CIN) during observational management. Consecutive women with histologically verified CIN and observational management were included. Histologic findings of initial and follow-up visits were collected and persistence, progression and regression rates at end of observational period were assessed. Uni- and multivariate analyses were performed. A systematic review of the literature and meta-analysis was performed. In 783 women CIN I, II, and III was diagnosed by colposcopically guided biopsy in 42.5%, 26.6% and 30.9%, respectively. Younger patients had higher rates of regression (p < 0.001) and complete remission (< 0.001) and lower rates of progression (p = 0.003). Among women aged < 25, 25 < 30, 30 < 35, 35 < 40 years, and > 40 years, regression rates were 44.7%, 33.7%, 30.9%, 27.3%, and 24.9%, respectively. Pooled analysis of published data showed similar results. Multivariable analysis showed that with each five years of age, the odds for regression reduced by 21% (p < 0.001) independently of CIN grade (p < 0.001), and presence of HPV high-risk infection (p < 0.001). Patient’s age has a considerable influence on the natural history of CIN – independent of CIN grade and HPV high-risk infection. Observational management should be considered for selected young patients with CIN.

Age-related Features of the Cytological Diagnosis of Cervical Dysplasia of Different Degrees

“…Observational management should be considered for selected young patients with CIN. (19)(20)(21)(22) Prevention, early detection, and effective treatment of malignant tumors is one of the most important sections of modern medicine. The WHO guideline provides recommendations for screening and treatment of precancerous lesions to prevent CC.…”

Establishment of Multifactor Predictive Models for the Occurrence and Progression of Cervical Intraepithelial Neoplasia

“…For women younger than 25 years old, regardless of the level of cervical lesions, the rate of spontaneous regression was 1.4 times higher than that of women older than 50 years old [24]. Christine Bekos [25] obtained similar results; the proportion of women over 40 years old who experienced CIN progression was signi cantly higher than the proportion who were younger than 40 years, and for every extra 5 years of age, despite cervical lesion grades, the rate of spontaneous regression decreased by 21%. The results of this study showed that the average age for patients with SCC is signi cantly greater than that of CIN patients, suggesting that age is likely to be related to the progression of CIN.…”

Establishment of multifactor predictive models for the occurrence and progression of cervical intraepithelial neoplasia

“…For women younger than 25 years old, regardless of the level of cervical lesions, the rate of spontaneous regression was 1.4 times higher than that of women older than 50 years old [24]. Christine Bekos [25] obtained similar results; the proportion of women over 40 years old who experienced CIN progression was significantly higher than the proportion who were younger than 40 years, and for every extra 5 years of age, despite cervical lesion grades, the rate of spontaneous regression decreased by 21%. The results of this study showed that the average age for patients with SCC is significantly greater than that of CIN patients, suggesting that age is likely to be related to the progression of CIN.…”