Regression of low-grade squamous intra-epithelial lesions in young women.
BACKGROUND
The aim of this study was to assess the probability of low-grade squamous intra-epithelial lesion (LSIL) regression in young women, and to examine the factors associated with this regression.


METHODS
In a longitudinal study of human papilloma virus (HPV) infection, female adolescents aged 13-22 years were examined every 4 months by cytology, colposcopy, and HPV DNA status. Both prevalent and incident LSIL cases were included in the analysis, with regression defined as at least three consecutive normal Pap smears.


RESULTS
Median follow-up time from baseline (defined as the time of first LSIL diagnosis) for the 187 women with LSIL was 61 months (IQR 34-80). Median time they had been sexually active at diagnosis was 3.2 years (2.6-6.5). Probability of regression for the entire cohort was 61% (95% CI 53-70) at 12 months and 91% (84-99) at 36 months of follow-up. No associations were found between LSIL regression and HPV status at baseline, sexual behaviour, contraceptive use, substance or cigarette use, incident sexually transmitted infection, or biopsy. Multivariate analysis showed that only HPV status at the current visit was associated with rate of regression, whether infection was caused by one or more viral types (relative hazard=0.3 [95% CI 0.21-0.42], and 0.14 [0.08-0.25], respectively).


CONCLUSIONS
The high rate of regression recorded in this study lends support to observation by cytology in the management of LSIL in female adolescents. Negative HPV status was associated with regression, suggesting that HPV testing could be helpful in monitoring LSIL.
Moscicki
Anna-Barbara
AB
Department of Pediatrics, University of California, San Francisco, CA, USA. annam@itsa.ucsf.edu
Shiboski
Stephen
S
Hills
Nancy K
NK
Powell
Kimberly J
KJ
Jay
Naomi
N
Hanson
Evelyn N
EN
Miller
Susanna
S
Canjura-Clayton
K Lisa
KL
Farhat
Sepidah
S
Broering
Jeanette M
JM
Darragh
Teresa M
TM
D000293:Adolescent; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D003127:Colposcopy; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D015999:Multivariate Analysis; D009365:Neoplasm Regression, Spontaneous; D065006:Papanicolaou Test; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology / Q000821:virology