NEW YORK (Reuters Health) Jul 18 - In many young women, cervical intraepithelial neoplasia (CIN) 2 can resolve on its own, according to a report from New Zealand.
"Internationally every year many thousands of young women with moderate abnormalities detected on their cervical smear undergo treatment. There is some evidence to suggest this treatment may increase the risk of premature birth," coauthor Dr. Peter H. H. Sykes told Reuters Health by email.
"This study demonstrates that a significant proportion of moderate cervical abnormalities in young women will resolve without treatment," he said. "However a smaller number of these women have significant abnormalities that do require treatment."
In their paper, published online June 27th in the American Journal of Obstetrics and Gynecology, Dr. Sykes of the University of Otago, Christchurch School of Medicine and colleagues review data on 452 women less than 25 years old with CIN2.
Slightly more than half the women -- 256, or 57% -- were treated immediately, 157 (35%) were treated conservatively and followed with regular colposcopy and cytology, and data on the others were incomplete.
The median length of follow-up was eight months, at which point 98 women (62%) in the conservative management group showed spontaneous regression. Although the remainder had persistent disease, there were no cases of progression to invasive cancer on follow-up for as long as 2 years.
"The implication for practice is that, it is appropriate to question whether young women with these abnormalities require treatment routinely or if a more selective approach should be taken," Dr. Sykes said.
But, he added, "At this stage we are unable to answer this question. Ongoing studies to demonstrate the safety of non treatment and to determine in which patients abnormalities are most likely to resolve spontaneously are required."
"Internationally every year many thousands of young women with moderate abnormalities detected on their cervical smear undergo treatment. There is some evidence to suggest this treatment may increase the risk of premature birth," coauthor Dr. Peter H. H. Sykes told Reuters Health by email.
"This study demonstrates that a significant proportion of moderate cervical abnormalities in young women will resolve without treatment," he said. "However a smaller number of these women have significant abnormalities that do require treatment."
In their paper, published online June 27th in the American Journal of Obstetrics and Gynecology, Dr. Sykes of the University of Otago, Christchurch School of Medicine and colleagues review data on 452 women less than 25 years old with CIN2.
Slightly more than half the women -- 256, or 57% -- were treated immediately, 157 (35%) were treated conservatively and followed with regular colposcopy and cytology, and data on the others were incomplete.
The median length of follow-up was eight months, at which point 98 women (62%) in the conservative management group showed spontaneous regression. Although the remainder had persistent disease, there were no cases of progression to invasive cancer on follow-up for as long as 2 years.
"The implication for practice is that, it is appropriate to question whether young women with these abnormalities require treatment routinely or if a more selective approach should be taken," Dr. Sykes said.
But, he added, "At this stage we are unable to answer this question. Ongoing studies to demonstrate the safety of non treatment and to determine in which patients abnormalities are most likely to resolve spontaneously are required."
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