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Follow up in women with biopsy diagnosis of cervical low-grade squamous intraepithelial lesion (LSIL): how long should it be?

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Aim

To analyse the regression rate and the risk of persistence or progression of the lesions in women with a histopathological diagnosis of cervical low-grade squamous intraepithelial lesion (LSIL).

Materials and methods

Retrospective cohort study of women with biopsy diagnosis of cervical LSIL, from January 2010 to December 2013. After the initial diagnosis of LSIL, all the women underwent scheduled follow-up examinations with cytology every 6 months for 2 years and an HPV test after 1 year.

Results

At the 24 -month follow-up, the regression of cervical LSIL was observed in 88.5% of the women. 10.8% of the women had a persistent lesion, while a progression towards cervical HSIL was reported in 0.7% of the women. The risk of persistence or progression of histological LSIL was higher in women with ASC-H or HSIL on the referral cytology and in tobacco users.

Conclusion

In women with biopsy diagnosis of cervical LSIL, preceded by ASCUS or LSIL on cytology, a high rate of regression was observed and, in most of the cases, the regression occurred in the first year of follow-up. In women with cervical LSIL, preceded by ASC-H or HSIL on cytology, and in tobacco users, a higher risk of persistence and progression was observed. Thus, in these cases, repeated follow-up examinations, even with the HR-HPV test, are advisable.

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References

  1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359–E386

    Article  CAS  PubMed  Google Scholar 

  2. Nogara PR, Manfroni LA, Consolaro ME (2013) Frequency of cervical intraepithelial neoplasia grade II or worse in women with a persistent low-grade squamous intraepithelial lesion seen by Papanicolaou smears. Arch Gynecol Obstet 288(5):1125–1230

    Article  CAS  PubMed  Google Scholar 

  3. Darragh TM, Colgan TJ, Cox JT, Heller DS, Henry MR, Luff RD, McCalmont T, Nayar R, Palefsky JM, Stoler MH, Wilkinson EJ, Zaino RJ, Wilbur DC; Members of LAST Project Work Groups (2012) The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology. J Low Genit Tract Dis 16(3):205–242.

    Article  PubMed  Google Scholar 

  4. Massad LS, Einstein MH, Huh WK, Katki HA, Kinney WK, Schiffman M, Solomon D, Wentzensen N, Lawson HW (2013) 2012 ASCCP Consensus Guidelines Conference. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis 17(5 Suppl 1):S1–S27

    Article  PubMed  Google Scholar 

  5. Cox JT, Schiffman M, Solomon D (2003) ASCUS-LSIL Triage Study (ALTS) Group. Prospective follow-up suggests similar risk of subsequent cervical intraepithelial neoplasia grade 2 or 3 among women with cervical intraepithelial neoplasia grade 1 or negative colposcopy and directed biopsy. Am J Obstet Gynecol 188(6):1406–1412

    Article  PubMed  Google Scholar 

  6. Moscicki AB, Shiboski S, Hills NK, Powell KJ, Jay N, Hanson EN, Miller S, Canjura-Clayton KL, Farhat S, Broering JM, Darragh TM (2004) Regression of low-grade squamous intra-epithelial lesions in young women. Lancet 364(9446):1678–1683

    Article  PubMed  Google Scholar 

  7. Jordan J, Martin-Hirsch P, Arbyn M, Schenck U, Baldauf JJ, Da Silva D, Anttila A, Nieminen P, Prendiville W (2009) European guidelines for clinical management of abnormal cervical cytology, part 2. Cytopathology 20(1):5–16

    Article  CAS  PubMed  Google Scholar 

  8. Nayar R, Wilbur DC (2015) The Pap Test and Bethesda 2014. J Low Genit Tract Dis 19(3):175–184

    Article  PubMed  Google Scholar 

  9. Bornstein J, Sideri M, Tatti S, Walker P, Prendiville W, Haefner HK; Nomenclature Committee of International Federation for Cervical Pathology and Colposcopy (2012) 2011 terminology of the vulva of the International Federation for Cervical Pathology and Colposcopy. J Low Genit Tract Dis. 16(3):290–295

    Article  PubMed  Google Scholar 

  10. Ostör AG (1993) Natural history of cervical intraepithelial neoplasia: a critical review. Int J Gynecol Pathol 12(2):186–192

    Article  PubMed  Google Scholar 

  11. Katki HA, Gage JC, Schiffman M, Castle PE, Fetterman B, Poitras NE, Lorey T, Cheung LC, Raine-Bennett T, Kinney WK (2013) Follow-up testing after colposcopy: five-year risk of CIN 2 + after a colposcopic diagnosis of CIN 1 or less. J Low Genit Tract Dis 17(5 Suppl 1):S69–S77

    Article  PubMed  PubMed Central  Google Scholar 

  12. Moscicki AB, Schiffman M, Kjaer S, Villa LL (2006) Chap. 5: updating the natural history of HPV and anogenital cancer. Vaccine. 31;24 Suppl 3:S3/42–51

  13. Plummer M, Herrero R, Franceschi S, Meijer CJ, Snijders P, Bosch FX, de Sanjosé S, Muñoz N; IARC Multi-centre Cervical Cancer Study Group (2003) Smoking and cervical cancer: pooled analysis of the IARC multi-centric case–control study. Cancer Causes Control. 14(9):805–814

    Article  PubMed  Google Scholar 

  14. Kjellberg L, Hallmans G, Ahren AM, Johansson R, Bergman F, Wadell G, Angström T, Dillner J (2000) Smoking, diet, pregnancy and oral contraceptive use as risk factors for cervical intra-epithelial neoplasia in relation to human papillomavirus infection. Br J Cancer 82(7):1332–1338

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Louie KS, Castellsague X, de Sanjose S, Herrero R, Meijer CJ, Shah K, Munoz N, Bosch FX; International Agency for Research on Cancer Multicenter Cervical Cancer Study Group (2011) Smoking and passive smoking in cervical cancer risk: pooled analysis of couples from the IARC multicentric case-control studies. Cancer Epidemiol Biomarkers Prev 20(7):1379–1390.

    Article  PubMed  Google Scholar 

  16. Zhang Q, Xie W, Wang F, Li RH, Cui L, Wang H, Fu X, Song J (2016) Epidemiological investigation and risk factors for cervical lesions: cervical cancer screening among women in rural areas of Henan Province China. Med Sci Monit 1(22):1858–1865

    Article  Google Scholar 

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Correspondence to Andrea Ciavattini.

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Author contribution statement

A Ciavattini: Protocol/project development, critical revision of the manuscript. N Clemente: drafting the manuscript and data analysis. D Tsiroglou: data collection. F Sopracordevole: critical revision of the manuscript. M Serri: data collection and analysis. G Delli Carpini: data analysis. M Papiccio: data collection. P Cattani: Protocol/project development. All authors take responsibility for the integrity of the work and for the approval of the final ‘to be published’ version.

Conflict of interest

We declare that we have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Funding

The present article is not under consideration for publication elsewhere. No sources of financial support are declared.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Ciavattini, A., Clemente, N., Tsiroglou, D. et al. Follow up in women with biopsy diagnosis of cervical low-grade squamous intraepithelial lesion (LSIL): how long should it be?. Arch Gynecol Obstet 295, 997–1003 (2017). https://doi.org/10.1007/s00404-017-4335-7

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  • DOI: https://doi.org/10.1007/s00404-017-4335-7

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