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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