Concentration Area: Women's Reproductive Health
- Authors: Karin Fuchs, MD, Sherry Weitzen, PhD, Lily Wu, BS, Maureen G. Phipps, MD, MPH, and Lori A. Boardman, MD, ScM
- Abstract: Abstract. Study Objective: To evaluate regression rates
among adolescents (aged #21) with cervical intraepithelial
neoplasia (CIN) 2 managed expectantly and to determine
factors associated with disease regression.
Design: Cohort study using a colposcopic database of
2,996women seen betweenAugust 1999 and November 2005.
Setting: Colposcopy clinic in urban, tertiary care medical
Participants: Adolescents with CIN 2. Routine management
consisted of two options: immediate treatment or repeat
colposcopic evaluation in 6 months.
Main Outcome Measures: For those managed conservatively,
regression was defined either as a subsequent normal
colposcopy and/or biopsy and at least 2 smears read as negative
for epithelial abnormality or at least 3 consecutive
negative smears if repeat colposcopy was not performed.
Demographic information, including age, was assessed to
determine possible associations with disease regression.
Results: Of the 93 adolescents, 53 (57%) elected to undergo
immediate treatment with a diagnostic excisional
procedure, and 40 (43%) chose management with colposcopic
follow-up. Of those treated, high-grade disease
(CIN 2þ) was found in 40 (75%). Of the 36 young women
followed conservatively (4 were lost to follow-up), regression
after a median follow-up time of 378 days was documented
in 14 (39%). Of the 22 adolescents not fulfilling
our criteria for regression, only 3 had evidence of CIN 2
or worse during follow-up. The remaining 19 had either
CIN 1 or mildly abnormal cytologic results. Kaplan-Meier
survival estimates indicated younger age (#16 years)
tended to be associated with decreased time to regression.
Conclusion: Based on significant regression of CIN 2
among adolescent women, primary management in this
population should consist of cytologic and colposcopic
- Journal: North American Society for Pediatric and Adolescent Gynecology
- Volume: 20
- Pages: 269-274
- Month: October
- Year: 2007
- Publisher: Elsevier Inc.
Management of Cervical Intraepithelial Neoplasia 2 in Adolescent and Young Women