Short-term Outcome of Cervical Intraepithelial Neoplasia Grade 2: Considerations for Management Strategies and Reproducibility of Diagnosis

• Published in: Anticancer research Vol. 30; no. 6; pp. 2319 - 2323
• Main Authors: GUEDES, Ana Claudia, CARLOS ZEFERINO, Luis, SYRJÄNEN, Kari Juhani, FERNANDES BRENNA, Sylvia Michelina
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01.06.2010
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Cervical Intraepithelial Neoplasia - diagnosis; Cervical Intraepithelial Neoplasia - pathology; Cervical Intraepithelial Neoplasia - surgery; Colposcopy; Female; Female genital diseases; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Middle Aged; Neoplasm Regression, Spontaneous; Prospective Studies; Reproducibility of Results; Treatment Outcome; Tumors; Uterine Cervical Neoplasms - diagnosis; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - surgery; Short term; Premalignant lesion; Prognosis; Spontaneous; Regression; Malignant tumor; Female genital diseases; female genital tract disease; Cancerology; Clinical management; Cervical dysplasia; Reproducibility; Cervical intraepithelial neoplasia; Female genital system; precancerous conditions; Diagnosis; Uterine cervix diseases; Cervical cancer; spontaneous neoplasm regression; Cancer
• ISSN: 0250-7005; 1791-7530

To compare two management strategies for cervical intraepithelial neoplasia (CIN) 2, and evaluate reproducibility of the diagnosis. Ninety (90) women with biopsy-proven CIN2 diagnosed through the Brazilian public health service were randomly allocated into two groups: 45 in prospective follow-up without treatment, and 45 for radical loop electrosurgical excision procedure (LLETZ). As in the real-life situation, pathology-reviewed diagnoses and HPV genotypes were not available. Excision of the lesion proved to be more effective than prospective follow-up in reaching clearance of CIN2 (hazard ratio=3.66; 95% confidence interval 2.02-6.64). However, 44.1% of the lesions regressed without treatment during the 12-month follow-up. CIN2 lesions regress without treatment in one year, although an ablative procedure is more effective. However, excision of CIN2 may lead to additional morbidity and costs, and tailoring the management on an individual basis may result in better outcome. Misclassification of CIN2 is not a negligible problem.