"Rates of regression of cervical dysplasia between initial biopsy and e" by Katrina Mark, Anja Frost et al.
 

Rates of regression of cervical dysplasia between initial biopsy and excisional procedure in routine clinical practice

Document Type

Journal Article

Publication Date

3-4-2019

Journal

Archives of Gynecology and Obstetrics

Volume

299

Issue

3

DOI

10.1007/s00404-018-5026-8

Keywords

Colposcopy; Human papillomavirus; Pap test; Spontaneous neoplasm regression; Squamous intraepithelial lesions

Abstract

© 2019, Springer-Verlag GmbH Germany, part of Springer Nature. 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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