STUDY OBJECTIVE: To evaluate regression rates among adolescents (aged < or =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 2,996 women seen between August 1999 and November 2005. SETTING: Colposcopy clinic in urban, tertiary care medical center. 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 2+) 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 (< or =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 follow-up.
STUDY OBJECTIVE: To evaluate regression rates among adolescents (aged < or =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 2,996 women seen between August 1999 and November 2005. SETTING: Colposcopy clinic in urban, tertiary care medical center. 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 2+) 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 (< or =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 follow-up.
Authors: Anna-Barbara Moscicki; Stephen Shiboski; Nancy K Hills; Kimberly J Powell; Naomi Jay; Evelyn N Hanson; Susanna Miller; K Lisa Canjura-Clayton; Sepidah Farhat; Jeanette M Broering; Teresa M Darragh Journal: Lancet Date: 2004 Nov 6-12 Impact factor: 79.321
Authors: A B Moscicki; N Hills; S Shiboski; K Powell; N Jay; E Hanson; S Miller; L Clayton; S Farhat; J Broering; T Darragh; J Palefsky Journal: JAMA Date: 2001-06-20 Impact factor: 56.272
Authors: G Y Ho; R D Burk; S Klein; A S Kadish; C J Chang; P Palan; J Basu; R Tachezy; R Lewis; S Romney Journal: J Natl Cancer Inst Date: 1995-09-20 Impact factor: 13.506
Authors: Gloria Y F Ho; Mark H Einstein; Seymour L Romney; Anna S Kadish; Maria Abadi; Magdy Mikhail; Jayasri Basu; Benjamin Thysen; Laura Reimers; Prabhudas R Palan; Shelly Trim; Nafisseh Soroudi; Robert D Burk Journal: J Low Genit Tract Dis Date: 2011-10 Impact factor: 1.925
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Authors: Lisa Beth Spiryda; Kara M Whitaker; Amy Messersmith; Carolyn E Banister; Kim E Creek; Lucia A Pirisi-Creek Journal: J Low Genit Tract Dis Date: 2016-01 Impact factor: 1.925