, Volume 1, Issue 2, pp 143-148

Risk of subsequent cytological abnormality and cancer among women with a history of cervical intraepithelial neoplasia: a comparative study

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A longitudinal study of 1,281 women with a histological diagnosis of cervical intraepithelial neoplasia (CIN) during 1974–76 is presented. After 12 years of follow-up, 30 percent of the women had further cytological abnormalities reported. The rate of subsequent abnormality was highest during the first 12 months of follow-up; thereafter, there was no evidence of any decline in the rate of subsequent abnormality with increasing duration of follow-up. Women from the CIN cohort had twice as many later cytological abnormalities as an age-matched cohort of women who were negatively screened during 1974–76 (excluding abnormalities within 12 months of entry to the study and after adjustment for smear frequency). The CIN cohort remained at substantially greater risk for a subsequent diagnosis of squamous cell carcinoma of the cervix compared with the control group of negatively-screened women (rate ratio 19.8, 95 percent confidence interval 2.4–163.6, P < 0.01). These results indicate that women who have received surgical intervention for CIN continue to have substantial morbidity from cervical abnormalities during medium-term follow-up.

Dr Mitchell is Epidemiologist and Deputy Director, Victorian Cytology (Gynaecological) Service, PO Box 253B, Melbourne 3001, Australia; Dr Medley is Director, Victorian Cytology (Gynaecological) Service: Dr Carlin is Lecturer in Statistics, Department of Commuity Medicine, University of Melbourne. Address reprint requests to Dr Mitchell. Dr Mitchell is supported in part by grants from the National Health and Medical Research Council and the Anti-Cancer Council of Victoria.