Cervical intraepithelial neoplasia in young women

Abstract

The aim of the study was to determine the incidence and outcome of cervical intraepithelial neoplasia (CIN) in Greek young women. A retrospective analysis was conducted of women aged 16 - 20 years with a histological diagnosis of CIN during the years 1999-2005. Management was individualised for each case. The rates of regression, persistence and progression were measured. A total of 80 adolescents were identified. Some 54 patients (67.5%) had CIN1 and 26 (32.5%) had CIN2/3. Regression of the CIN1 lesions expressed as negative cytological or histological follow-up was observed in 74% and 93% of the patients at 12 and 24 months, respectively. The majority of adolescents (92%) with CIN2/3 underwent conisation and in 79% of them, histology of the specimen confirmed the initial diagnosis. CIN1 lesions will most likely regress over a 2-year period following diagnosis in women aged 16 - 20 years. Nevertheless, close monitoring is mandatory, as 10 - 15% of these lesions will either persist or progress to high-grade CIN. Management for adolescents with high-grade CIN lesions should be individualised according to a variety of parameters and adjusted to the patients' safety.

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

“…For 36 studies, the risk of bias was determined as low (Supplementary Table 4, http://links.lww.com/LGT/A242). High risk of bias was in most studies caused by the unrepresentativeness of the cohort for the full population in a predefined period 11–13,24,27,28,30,32–34,36,37,40,42–44,48,50,51,53,57,59,61,71,73–77,79,83–88,91–93,95 and the low number of participants in the study 8,9,11,12,26,27,34,36,37,39,42–44,49,53,56,58,62,63,68,69,71–73,75,76,78,81,84,95 . The subgroup analysis for studies with low or high risk of bias showed no statistically significant differences between the 3 different outcomes for each CIN grade.…”

“…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.…”

“…For 36 studies, the risk of bias was determined as low (Supplementary Table 4, http://links.lww.com/LGT/A242). High risk of bias was in most studies caused by the unrepresentativeness of the cohort for the full population in a predefined period [11][12][13]24,27,28,30,[32][33][34]36,37,40,[42][43][44]48,50,51,53,57,59,61,71,[73][74][75][76][77]79,[83][84][85][86][87][88][91][92][93]95 and the low number of participants in the study. 8,9,11,12,26,27,34,36,37,…”