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

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

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 +.

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Funding

The authors have no funding to disclose.

Author information

Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, 11 S Paca Street, Suite 400, Baltimore, MD, 21201, USA

    Katrina Mark & Opey Solaru

  2. Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Anja Frost, Anne E. Burke & Jill Edwardson

  3. Department of Epidemiology and Biostatistics, The George Washington University, Washington, DC, USA

    Heather Hussey

  4. Division of Gynecologic Oncology, The George Washington University Hospital, Washington, DC, USA

    Micael Lopez-Acevedo

  5. Department of Global Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA

    Patti Gravitt

Authors
  1. Katrina Mark
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  2. Anja Frost
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  3. Heather Hussey
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  4. Micael Lopez-Acevedo
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  5. Anne E. Burke
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  6. Jill Edwardson
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Contributions

KM: project development, data collection, manuscript writing. AF: project development, data collection, manuscript editing. HH: project development, data analysis. ML-A: project development, manuscript editing. AB: data collection, manuscript editing. JE: data collection. OS: data collection. PG: project development, data analysis, manuscript writing.

Corresponding author

Correspondence to Katrina Mark.

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The authors report no conflicts of interest.

Additional information

This study was approved by the Institutional Review Boards of University of Maryland, Johns Hopkins University and George Washington University.

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Mark, K., Frost, A., Hussey, H. et al. Rates of regression of cervical dysplasia between initial biopsy and excisional procedure in routine clinical practice. Arch Gynecol Obstet 299, 841–846 (2019). https://doi.org/10.1007/s00404-018-5026-8

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  • DOI: https://doi.org/10.1007/s00404-018-5026-8

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