title: Regression of low-grade squamous intra-epithelial lesions in young women.
abstract: 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.
authors.affiliation: Department of Pediatrics, University of California, San Francisco, CA, USA. annam@itsa.ucsf.edu
authors.forename: Anna-Barbara
authors.initials: AB
authors.lastname: Moscicki
authors.forename: Stephen
authors.initials: S
authors.lastname: Shiboski
authors.forename: Nancy K
authors.initials: NK
authors.lastname: Hills
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Powell
authors.forename: Naomi
authors.initials: N
authors.lastname: Jay
authors.forename: Evelyn N
authors.initials: EN
authors.lastname: Hanson
authors.forename: Susanna
authors.initials: S
authors.lastname: Miller
authors.forename: K Lisa
authors.initials: KL
authors.lastname: Canjura-Clayton
authors.forename: Sepidah
authors.initials: S
authors.lastname: Farhat
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Broering
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Darragh
mesh_terms: 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