Katrina Mark1, Anja Frost2, Heather Hussey3, Micael Lopez-Acevedo4, Anne E Burke2, Jill Edwardson2, Opey Solaru5, Patti Gravitt6. 1. Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, 11 S Paca Street, Suite 400, Baltimore, MD, 21201, USA. kmark@som.umaryland.edu. 2. Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 3. Department of Epidemiology and Biostatistics, The George Washington University, Washington, DC, USA. 4. Division of Gynecologic Oncology, The George Washington University Hospital, Washington, DC, USA. 5. Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, 11 S Paca Street, Suite 400, Baltimore, MD, 21201, USA. 6. Department of Global Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Abstract
PURPOSE: To determine rates and factors associated with regression of cervical intraepithelial neoplasia (CIN) 2 + between colposcopic biopsy and therapeutic excisional procedure in standard practice. METHODS: A retrospective chart review was performed for women undergoing a cervical excisional procedure for CIN 2 + at clinics at three academic institutions over a 3-year period. Cytology, histology, patient age and time-to-excision were analyzed to determine factors influencing rates of regression. RESULTS: Of 356 women undergoing excision for CIN 2 + on colposcopic biopsy, 91 (25.3%) of final pathology diagnoses displayed clinically significant regression. Age and time-to-excision were not associated with regression, but referral cytology and severity of initial biopsy histology were, with ASC-H (aOR 0.1, CI 0.03, 0.8) and CIN 3/AIS (aOR 0.4, CI 0.2, 0.7) being less likely to regress than less severe lesions. CONCLUSIONS: Disease severity by referral cytology or diagnostic biopsy, as opposed to age or length of time-to-excision, is likely the most relevant factor in determination of regression for cervical intraepithelial neoplasia in women undergoing excisional treatment for biopsy-confirmed CIN2 +.
PURPOSE: To determine rates and factors associated with regression of cervical intraepithelial neoplasia (CIN) 2 + between colposcopic biopsy and therapeutic excisional procedure in standard practice. METHODS: A retrospective chart review was performed for women undergoing a cervical excisional procedure for CIN 2 + at clinics at three academic institutions over a 3-year period. Cytology, histology, patient age and time-to-excision were analyzed to determine factors influencing rates of regression. RESULTS: Of 356 women undergoing excision for CIN 2 + on colposcopic biopsy, 91 (25.3%) of final pathology diagnoses displayed clinically significant regression. Age and time-to-excision were not associated with regression, but referral cytology and severity of initial biopsy histology were, with ASC-H (aOR 0.1, CI 0.03, 0.8) and CIN 3/AIS (aOR 0.4, CI 0.2, 0.7) being less likely to regress than less severe lesions. CONCLUSIONS: Disease severity by referral cytology or diagnostic biopsy, as opposed to age or length of time-to-excision, is likely the most relevant factor in determination of regression for cervical intraepithelial neoplasia in women undergoing excisional treatment for biopsy-confirmed CIN2 +.
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Keywords:
Colposcopy; Human papillomavirus; Pap test; Spontaneous neoplasm regression; Squamous intraepithelial lesions