Women previously treated for a high-grade squamous cervical intraepithelial lesion (CIN3) are at increased risk of cervical cancer and must be treated. However, recent research suggests CIN2 lesions in younger patients may be managed conservatively.
To investigate health outcomes of conservatively managed young patients with CIN2.
A retrospective investigation was performed for patients aged 18 to <25 years with biopsy confirmed CIN2 for 01-Jan-2001 to 31-Dec-2012. Patient’s cervical test results were linked with hospital morbidity records to confirm treatment (ablative and/or excisional). Patients treated within 4 months of receiving their CIN2 diagnosis were allocated to the “immediate treatment” group. Patients who remained untreated at ≥4 months were allocated to the “conservative management” group. Regression was defined as a lower grade epithelial lesion than CIN2.
Of the 2,960 patients identified, 1,970 (66.6%) were treated immediately and 990 (33.4%) met the definition for conservative treatment. The median follow-up time was 3.4 years (min <1 year and max 12 years) and mean patient age was 21.6 years. Of the patients treated conservatively, cervical pathology results reported disease persistence for 361 patients (36.4%). One patient was histologically confirmed with squamous cell carcinoma (approximately 5 years post CIN2 diagnosis). Disease regression was observed for 63.5% of patients that were conservatively managed.
This study observed a high regression rate for patients conservatively managed; however, these patients should remain under routine surveillance. Thus ‘see and treat’ protocols may not be necessary for women aged 18 to <25 with CIN2.