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

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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Corresponding author

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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Keywords

  • Cervical intraepithelial neoplasia
  • CIN1
  • Follow-up
  • Regression
  • Persistence
  • LSIL