title: Natural history of cervical intraepithelial neoplasia: a meta-analysis.
abstract: OBJECTIVE
  To determine the probabilities of transition of stages in the cervical cancer by conducting a meta-studies on the topic.
  
  
  METHODS
  We identified health states of interest in the natural history of cervical precancer, identified all possible papers that could meet selection criteria, developed relevance and acceptability criteria for inclusion, then thoroughly reviewed the selected studies. To determine the transition probability data we used a random effects model. We determined probabilities for 4 health state transitions. The 6-month mean predictive transition probability (95% confidence intervals with "prediction interval" in parentheses) for high grade squamous intraepithelial lesions (HSIL) to cancer was 0.0037 (0.00004, 0.03386), for low grade squamous intraepithelial lesions (LSIL) to HSIL was 0.0362 (0.00055, 0.23220), for HSIL to LSIL was 0.0282 (0.00027, 0.35782), and for LSIL to normal was 0.0740 (0.00119, 0.42672).
  
  
  CONCLUSIONS
  The transition probabilities between cervical cancer health states for 6-month intervals are small; however, the cumulative risk of cervical cancer is significant. Markers to identify the cervical precursors that will lead to the transition to cervical cancer are needed.
authors.affiliation: Department of Biostatistics and Applied Mathematics, The University of Texas M.D. Anderson Cancer Center, Houston, Texas77030-4009, USA. sbcantor@mdanderson.org
authors.forename: Scott B
authors.initials: SB
authors.lastname: Cantor
authors.forename: E Neely
authors.initials: EN
authors.lastname: Atkinson
authors.forename: Marylou
authors.initials: M
authors.lastname: Cardenas-Turanzas
authors.forename: J L
authors.initials: JL
authors.lastname: Benedet
authors.forename: Michele
authors.initials: M
authors.lastname: Follen
authors.forename: Calum
authors.initials: C
authors.lastname: MacAulay
mesh_terms: D016001:Confidence Intervals; D005260:Female; D006801:Humans; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000473:pathology*; D011336:Probability; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology*