Spontaneous regression of CIN2 in women aged 18–24 years: a retrospective study of a state‐wide population in Western Australia

Abstract

In conservatively managed young women with CIN2 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.

Clinical course of untreated cervical intraepithelial neoplasia grade 2 under active surveillance: systematic review and meta-analysis

“…We identified 250 potentially eligible studies; 43 publications met the inclusion criteria (fig 1),6222324252627282930313233343536373839404142434445464748495051525354555657585960616263 but seven were duplicate reports of the same data 27283140505254. Of the 36 eligible studies (total of 3160 women), seven (19%) were randomised trials with suitable data in the non-experimental arm,22253339455762 16 (44%) were prospective cohort studies,6263032343536373841435155566063 and 13 (36%) were retrospective cohort studies23242942444647484953585961 (see supplementary table 2).…”

“…Of the 36 eligible studies (total of 3160 women), seven (19%) were randomised trials with suitable data in the non-experimental arm,22253339455762 16 (44%) were prospective cohort studies,6263032343536373841435155566063 and 13 (36%) were retrospective cohort studies23242942444647484953585961 (see supplementary table 2). The median follow-up was 16 months (range 3-72, interquartile range 7.6-27.4 months).…”

“…The largest study included 924 women and the smallest included 12 women. Most studies (n=29, 81%) were small, with fewer than 100 women, and seven (19%) studies included only women aged less than 25 6294244484953. Twenty nine (81%) studies defined progression as a histological diagnosis of CIN3 or worse, whereas in seven of the 36 (19%) studies, worsening cytology was considered sufficient.…”

“…The rate was as low as 5% at three months (three studies, 7/133 women, 2% to 10%; I 2 =0%) and progressively increased from 14% at 12 months (13 studies, 131/834 women, 9% to 20%; I 2 =75%) to 18% at 24 months (nine studies, 282/1445 women, 11% to 27%; I 2 =90%) and 24% at 36 months (three studies, 105/370 women, 12% to 39%; I 2 =87%). Among the 3160 women, a total of 15 cases (0.5%, 15/3160) of cervical glandular intraepithelial neoplasia (cGIN; British Society of Colposcopy and Cervical Pathology classification—also known as adenocarcinoma in situ, AIS; Bethesda classification) were diagnosed during the follow-up period 425355. Fifteen cases of invasive cervical disease occurred (0.5%, 15/3160); 13 of stage 1A1 (0.4%, 13/3160) and two of more advanced invasive disease (0.06%, 2/3160) 23363739…”

Loop electrosurgical excision procedure versus expectant management to treat high-grade squamous intraepithelial lesion in women up to 25 years

“…Although studies involving young women exclusively with CIN2 1,[5][6][7]13 claim that the high regression rates found support only after clinical observation in these cases, prospective studies such as these that provide safety for clinicians and patients are scarce. In addition, it is important to consider that any patient with histopathological diagnosis of CIN2/3 is afraid to observe the lesion only every six months and many will not be able to guarantee the rigorous follow-up until spontaneous regression, or even the need for surgical therapy due to persistence or progression of the high-grade lesion.…”