Adolescent cervical dysplasia: histologic evaluation, treatment, and outcomes

• Published in: American journal of obstetrics and gynecology 2007-08, Vol.197 (2), p.141.e1-141.e6
• Main Authors: Moore, Kathleen, MD, Cofer, Amanda, DO, Elliot, Leslie, MD, Lanneau, Grainger, MD, Walker, Joan, MD, Gold, Michael A., MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Cervical Intraepithelial Neoplasia - epidemiology; Cervical Intraepithelial Neoplasia - pathology; Cervical Intraepithelial Neoplasia - surgery; CIN; Colposcopy; dysplasia; Female; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Obstetrics and Gynecology; Papillomavirus Infections - epidemiology; Prevalence; Retrospective Studies; Treatment Outcome; Uterine Cervical Dysplasia - epidemiology; Uterine Cervical Dysplasia - pathology; Uterine Cervical Dysplasia - surgery; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - surgery; Vaginal Smears
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2007.03.029

Objective The purpose of this study was to evaluate histologic findings and outcomes among adolescents with cervical dysplasia. Study Design Patient charts (2001-2005) were reviewed. Prevalence of cervical intraepithelial neoplasia (CIN) grades 2 and 3 and progression and regression were recorded. Results Five hundred one patients were identified. On biopsy, 324 patients (65%) had CIN 1 or less, and 177 patients (35%) had CIN ≥2. Twenty-nine percent of the patients with CIN 2 opted for conservative treatment vs excision. Over 18 months, the condition of 65% of the patients regressed; the condition of 20% of the patients was stable, and the condition of 5% of the patients progressed without cancer. Of the patients who underwent excision (follow-up median, 26 months), 84% experienced regression of their condition; the condition of 11% was persistent, and 5% progressed with no cancer. Conclusion CIN ≥2 is present in 35% of our cohort. Most had CIN 2, and most experienced regression. Our observation supports continued vigilance in the evaluation of adolescents but suggests that less intervention for CIN 2 may be acceptable.