Diede L Loopik1, Ruud L M Bekkers2, Leon F A G Massuger3, Willem J G Melchers4, Albert G Siebers5, James Bentley6. 1. Department of Obstetrics and Gynecology, Radboud university medical center, PO Box 9101, 6500HB Nijmegen, the Netherlands. Electronic address: diede.loopik@radboudumc.nl. 2. Department of Obstetrics and Gynecology, Catharina Hospital Eindhoven, PO Box 1350, 5602ZA, the Netherlands. Electronic address: ruud.bekkers@radboudumc.nl. 3. Department of Obstetrics and Gynecology, Radboud university medical center, PO Box 9101, 6500HB Nijmegen, the Netherlands. Electronic address: leon.massuger@radboudumc.nl. 4. Department of Medical Microbiology, Radboud University Medical Center, PO Box 9101, 6500HB Nijmegen, the Netherlands. Electronic address: willem.melchers@radboudumc.nl. 5. Department of Pathology, Radboud University Medical Center, PO Box 9101, 6500HB Nijmegen, the Netherlands. Electronic address: bert.siebers@radboudumc.nl. 6. Division of Gynecologic Oncology, Queen Elizabeth II Health Sciences Centre, 5820 University Avenue, Halifax, NS B3H 1Y9, Canada. Electronic address: jim.bentley@dal.ca.
Abstract
OBJECTIVE: In 2012, the joint clinical practice guideline from the Society of Obstetricians and Gynaecologists of Canada (SOGC) changed from immediate treatment to a more conservative management of Cervical Intraepithelial Neoplasia (CIN) grade 2 in young women. In this study, the outcomes before and after this management change were reviewed in Nova Scotia, Canada. METHODS: A retrospective population-based cohort study was performed among women younger than 25 years with biopsy-proven CIN2, who were diagnosed in one of the colposcopy clinics in Nova Scotia between 2010 and 2014. Regression and progression rates were compared pre- and post-guideline changes. RESULTS: Of the 636 women included in the study, 286 women were diagnosed with CIN2 before and 350 women after the management in Nova Scotia was changed. After implementation of the 2012 guidelines patients were more likely to receive conservative management (78.6% versus 44.1%; p < 0.001); which differs from the patients who underwent treatment during follow-up prior to the change in guidelines (73.4% versus 38.9%; p < 0.001). Regression occurred in 73.1% of all women, but women seen in the post-guideline change period had a higher regression rate and lower progression rate (p < 0.05). Histologic results from treatment specimen did not show a significant difference in low-grade or high-grade lesions before or after the guideline had been changed (p = 0.59). CONCLUSION: Conservative management seems a safe and justified approach for women younger than 25 years with CIN2.
OBJECTIVE: In 2012, the joint clinical practice guideline from the Society of Obstetricians and Gynaecologists of Canada (SOGC) changed from immediate treatment to a more conservative management of Cervical Intraepithelial Neoplasia (CIN) grade 2 in young women. In this study, the outcomes before and after this management change were reviewed in Nova Scotia, Canada. METHODS: A retrospective population-based cohort study was performed among women younger than 25 years with biopsy-proven CIN2, who were diagnosed in one of the colposcopy clinics in Nova Scotia between 2010 and 2014. Regression and progression rates were compared pre- and post-guideline changes. RESULTS: Of the 636 women included in the study, 286 women were diagnosed with CIN2 before and 350 women after the management in Nova Scotia was changed. After implementation of the 2012 guidelines patients were more likely to receive conservative management (78.6% versus 44.1%; p < 0.001); which differs from the patients who underwent treatment during follow-up prior to the change in guidelines (73.4% versus 38.9%; p < 0.001). Regression occurred in 73.1% of all women, but women seen in the post-guideline change period had a higher regression rate and lower progression rate (p < 0.05). Histologic results from treatment specimen did not show a significant difference in low-grade or high-grade lesions before or after the guideline had been changed (p = 0.59). CONCLUSION: Conservative management seems a safe and justified approach for women younger than 25 years with CIN2.
Authors: Meike Schild-Suhren; Helge Ho Müller; Stephanie Klügel; Caroline Lücke; Aylin Mehren; Eduard Malik; Alexandra Philipsen Journal: Int J Womens Health Date: 2019-09-12
Authors: Mayumi Saito; Aarthi Rajesh; Carrie Innes; Rachael van der Griend; Peter Fitzgerald; Bryony Simcock; Peter Sykes; Merilyn Hibma Journal: J Cancer Res Clin Oncol Date: 2022-04-06 Impact factor: 4.322