Rates of regression of cervical dysplasia between initial biopsy and excisional procedure in routine clinical practice

Katrina Mark, Anja Frost, Heather Hussey, Micael Lopez-Acevedo, Anne E. Burke, Jill Edwardson, Opey Solaru, Patti E. Gravitt

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To determine rates and factors associated with regression of cervical intraepithelial neoplasia (CIN) 2 + between colposcopic biopsy and therapeutic excisional procedure in standard practice. Methods: A retrospective chart review was performed for women undergoing a cervical excisional procedure for CIN 2 + at clinics at three academic institutions over a 3-year period. Cytology, histology, patient age and time-to-excision were analyzed to determine factors influencing rates of regression. Results: Of 356 women undergoing excision for CIN 2 + on colposcopic biopsy, 91 (25.3%) of final pathology diagnoses displayed clinically significant regression. Age and time-to-excision were not associated with regression, but referral cytology and severity of initial biopsy histology were, with ASC-H (aOR 0.1, CI 0.03, 0.8) and CIN 3/AIS (aOR 0.4, CI 0.2, 0.7) being less likely to regress than less severe lesions. Conclusions: Disease severity by referral cytology or diagnostic biopsy, as opposed to age or length of time-to-excision, is likely the most relevant factor in determination of regression for cervical intraepithelial neoplasia in women undergoing excisional treatment for biopsy-confirmed CIN2 +.

Original languageEnglish (US)
JournalArchives of Gynecology and Obstetrics
DOIs
StateAccepted/In press - Jan 1 2019

Keywords

  • Colposcopy
  • Human papillomavirus
  • Pap test
  • Spontaneous neoplasm regression
  • Squamous intraepithelial lesions

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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