Spontaneous regression of CIN2 in women aged 18-24 years: A retrospective study of a state-wide population in Western Australia

A. Munro, R.G. Powell, Paul Cohen, S. Bowen, K. Spilsbury, P. O'Leary, J.B. Semmens, J. Codde, V. Williams, N. Steel, Yee Leung

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    Abstract

    © 2015 Nordic Federation of Societies of Obstetrics and Gynecology. Introduction CIN2 has a high rate of spontaneous regression in young women and may be managed conservatively in appropriately selected patients. This study aimed to investigate health outcomes in women aged 18-24 years with biopsy-confirmed CIN2. Material and methods A retrospective cohort study of Western Australian women aged 18-24 years diagnosed with CIN2 on cervical biopsy from 1 January 2001 to 31 December 2010. Women who had not received treatment at ≥4 months following CIN2 diagnosis were classified as managed 'conservatively'. Subsequent cervical cytology and/or biopsy test results were used to report lesion regression (absence of dysplasia or an epithelial lesion of lower grade than CIN2) and disease persistence (CIN2, CIN3 or ACIS). Results Follow-up data were available for 2417 women of whom 924 (38.2%) were 'conservatively' managed. In all, 152 (16.4%) conservatively managed women had a lesion more severe than CIN2 detected within 24 months of initial diagnosis, of which 144 were CIN3 and eight were ACIS. There was no statistically significant association between rates of regression and patient age, Socio-economic Indexes for Areas or Accessibility/Remoteness Index of Australia indices. The 2-year regression rate for CIN2 was estimated to be 59.5% (95%CI 0.5-0.6) in this cohort of women. Conclusion In conservatively managed young women with CIN2 there was a high rate of spontaneous disease regression. Thus, excisional or ablative treatments may be avoided in selected patients who receive appropriate counseling and who are able to comply with more intensive and prolonged follow-up requirements.
    Original languageEnglish
    Pages (from-to)291-298
    JournalActa Obstetricia et Gynecologica Scandinavica
    Volume95
    Issue number3
    DOIs
    Publication statusPublished - 2016

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    Western Australia
    Retrospective Studies
    Population
    Biopsy
    Cell Biology
    Counseling
    Cohort Studies
    Economics
    Health
    Therapeutics

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    Munro, A. ; Powell, R.G. ; Cohen, Paul ; Bowen, S. ; Spilsbury, K. ; O'Leary, P. ; Semmens, J.B. ; Codde, J. ; Williams, V. ; Steel, N. ; Leung, Yee. / Spontaneous regression of CIN2 in women aged 18-24 years: A retrospective study of a state-wide population in Western Australia. In: Acta Obstetricia et Gynecologica Scandinavica. 2016 ; Vol. 95, No. 3. pp. 291-298.
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    title = "Spontaneous regression of CIN2 in women aged 18-24 years: A retrospective study of a state-wide population in Western Australia",
    abstract = "{\circledC} 2015 Nordic Federation of Societies of Obstetrics and Gynecology. Introduction CIN2 has a high rate of spontaneous regression in young women and may be managed conservatively in appropriately selected patients. This study aimed to investigate health outcomes in women aged 18-24 years with biopsy-confirmed CIN2. Material and methods A retrospective cohort study of Western Australian women aged 18-24 years diagnosed with CIN2 on cervical biopsy from 1 January 2001 to 31 December 2010. Women who had not received treatment at ≥4 months following CIN2 diagnosis were classified as managed 'conservatively'. Subsequent cervical cytology and/or biopsy test results were used to report lesion regression (absence of dysplasia or an epithelial lesion of lower grade than CIN2) and disease persistence (CIN2, CIN3 or ACIS). Results Follow-up data were available for 2417 women of whom 924 (38.2{\%}) were 'conservatively' managed. In all, 152 (16.4{\%}) conservatively managed women had a lesion more severe than CIN2 detected within 24 months of initial diagnosis, of which 144 were CIN3 and eight were ACIS. There was no statistically significant association between rates of regression and patient age, Socio-economic Indexes for Areas or Accessibility/Remoteness Index of Australia indices. The 2-year regression rate for CIN2 was estimated to be 59.5{\%} (95{\%}CI 0.5-0.6) in this cohort of women. Conclusion In conservatively managed young women with CIN2 there was a high rate of spontaneous disease regression. Thus, excisional or ablative treatments may be avoided in selected patients who receive appropriate counseling and who are able to comply with more intensive and prolonged follow-up requirements.",
    author = "A. Munro and R.G. Powell and Paul Cohen and S. Bowen and K. Spilsbury and P. O'Leary and J.B. Semmens and J. Codde and V. Williams and N. Steel and Yee Leung",
    year = "2016",
    doi = "10.1111/aogs.12835",
    language = "English",
    volume = "95",
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    Spontaneous regression of CIN2 in women aged 18-24 years: A retrospective study of a state-wide population in Western Australia. / Munro, A.; Powell, R.G.; Cohen, Paul; Bowen, S.; Spilsbury, K.; O'Leary, P.; Semmens, J.B.; Codde, J.; Williams, V.; Steel, N.; Leung, Yee.

    In: Acta Obstetricia et Gynecologica Scandinavica, Vol. 95, No. 3, 2016, p. 291-298.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Spontaneous regression of CIN2 in women aged 18-24 years: A retrospective study of a state-wide population in Western Australia

    AU - Munro, A.

    AU - Powell, R.G.

    AU - Cohen, Paul

    AU - Bowen, S.

    AU - Spilsbury, K.

    AU - O'Leary, P.

    AU - Semmens, J.B.

    AU - Codde, J.

    AU - Williams, V.

    AU - Steel, N.

    AU - Leung, Yee

    PY - 2016

    Y1 - 2016

    N2 - © 2015 Nordic Federation of Societies of Obstetrics and Gynecology. Introduction CIN2 has a high rate of spontaneous regression in young women and may be managed conservatively in appropriately selected patients. This study aimed to investigate health outcomes in women aged 18-24 years with biopsy-confirmed CIN2. Material and methods A retrospective cohort study of Western Australian women aged 18-24 years diagnosed with CIN2 on cervical biopsy from 1 January 2001 to 31 December 2010. Women who had not received treatment at ≥4 months following CIN2 diagnosis were classified as managed 'conservatively'. Subsequent cervical cytology and/or biopsy test results were used to report lesion regression (absence of dysplasia or an epithelial lesion of lower grade than CIN2) and disease persistence (CIN2, CIN3 or ACIS). Results Follow-up data were available for 2417 women of whom 924 (38.2%) were 'conservatively' managed. In all, 152 (16.4%) conservatively managed women had a lesion more severe than CIN2 detected within 24 months of initial diagnosis, of which 144 were CIN3 and eight were ACIS. There was no statistically significant association between rates of regression and patient age, Socio-economic Indexes for Areas or Accessibility/Remoteness Index of Australia indices. The 2-year regression rate for CIN2 was estimated to be 59.5% (95%CI 0.5-0.6) in this cohort of women. Conclusion In conservatively managed young women with CIN2 there was a high rate of spontaneous disease regression. Thus, excisional or ablative treatments may be avoided in selected patients who receive appropriate counseling and who are able to comply with more intensive and prolonged follow-up requirements.

    AB - © 2015 Nordic Federation of Societies of Obstetrics and Gynecology. Introduction CIN2 has a high rate of spontaneous regression in young women and may be managed conservatively in appropriately selected patients. This study aimed to investigate health outcomes in women aged 18-24 years with biopsy-confirmed CIN2. Material and methods A retrospective cohort study of Western Australian women aged 18-24 years diagnosed with CIN2 on cervical biopsy from 1 January 2001 to 31 December 2010. Women who had not received treatment at ≥4 months following CIN2 diagnosis were classified as managed 'conservatively'. Subsequent cervical cytology and/or biopsy test results were used to report lesion regression (absence of dysplasia or an epithelial lesion of lower grade than CIN2) and disease persistence (CIN2, CIN3 or ACIS). Results Follow-up data were available for 2417 women of whom 924 (38.2%) were 'conservatively' managed. In all, 152 (16.4%) conservatively managed women had a lesion more severe than CIN2 detected within 24 months of initial diagnosis, of which 144 were CIN3 and eight were ACIS. There was no statistically significant association between rates of regression and patient age, Socio-economic Indexes for Areas or Accessibility/Remoteness Index of Australia indices. The 2-year regression rate for CIN2 was estimated to be 59.5% (95%CI 0.5-0.6) in this cohort of women. Conclusion In conservatively managed young women with CIN2 there was a high rate of spontaneous disease regression. Thus, excisional or ablative treatments may be avoided in selected patients who receive appropriate counseling and who are able to comply with more intensive and prolonged follow-up requirements.

    U2 - 10.1111/aogs.12835

    DO - 10.1111/aogs.12835

    M3 - Article

    VL - 95

    SP - 291

    EP - 298

    JO - Acta Obstetricia et Gynecologica

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