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Postcolposcopy management of women With histologically proven CIN 1
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Gurumurthy, Mahalakshmi, Cotton, Seonaidh C., Sharp, Linda, Smart, Louise, Little, Julian, Waugh, Norman and Cruickshank, M. (Margaret) (2014) Postcolposcopy management of women With histologically proven CIN 1. Journal of Lower Genital Tract Disease, Volume 18 (Number 3). pp. 203-209. doi:10.1097/LGT.0b013e3182a1772c ISSN 1089-2591.
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Official URL: http://dx.doi.org/10.1097/LGT.0b013e3182a1772c
Abstract
OBJECTIVES:
This study aimed to determine during 36 months of follow-up the (1) clinical outcomes and (2) influence of high-risk human papillomavirus (HPV) status on the risk of progression to cervical intraepithelial neoplasia 2+ (CIN 2+), among women with histologically proven CIN 1.
MATERIALS AND METHODS:
This is an ad hoc analysis of women with CIN 1 within TOMBOLA, a randomized trial of the management of women with low-grade cervical cytology. Women from the colposcopy arm with CIN 1 confirmed on punch biopsies and managed conservatively by cytology every 6 months in primary care were included. Sociodemographic data and a sample for HPV testing were collected at recruitment. Data on the sample women were extracted to calculate the cumulative incidence of CIN 2+ and the performance characteristics of the baseline HPV test. Detection of CIN 2 or worse (CIN 2+) during follow-up or at exit colposcopy was analyzed.
RESULTS:
A total of 171 women were included. Their median age was 29 years. Fifty-two percent were high-risk HPV positive, 17% were HPV-16 positive, and 11% were HPV-18 positive. Overall, 21 women (12%) developed CIN 2+, with a median time to detection of 25 months. Factors associated with progression to CIN 2+ were presence of HPV-18 (relative risk = 3.04; 95% CI = 1.09-8.44) and HPV-16 and/or HPV-18 at recruitment (relative risk = 3.98; 95% CI = 1.60-9.90). The sensitivity and specificity of a combined HPV-16/HPV-18 test for the detection of CIN 2+ during 3 years were 58% and 78%, respectively.
CONCLUSIONS:
Our results suggest that women with confirmed CIN 1 have low rates of progression to high-grade CIN within 3 years. Because the median time to progression was 25 months, conservative management could recommend the next repeat cytology at 2 years.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Journal of Lower Genital Tract Disease | ||||
Publisher: | Lippencott Williams & Wilkins | ||||
ISSN: | 1089-2591 | ||||
Official Date: | July 2014 | ||||
Dates: |
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Volume: | Volume 18 | ||||
Number: | Number 3 | ||||
Page Range: | pp. 203-209 | ||||
DOI: | 10.1097/LGT.0b013e3182a1772c | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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