Risks for cervical intraepithelial neoplasia 3 among adolescents and young women with abnormal cytology.
OBJECTIVE
To estimate the risks of cervical intraepithelial neoplasia (CIN) 3 among girls and women aged 13 to 24 years who were referred for abnormal cytology while receiving care in a large health maintenance organization.


METHODS
At the time of referral, patients had a colposcopic examination and biopsy if needed. Histology was sent to a centralized laboratory. Patients were interviewed for risk behaviors. Data analysis included multinomial logistic regression analysis to compare three groups: CIN 3 to CIN 1 or less, CIN 3 to CIN 2, and CIN 2 to CIN 1 or benign.


RESULTS
Cervical intraepithelial neoplasia-3 was found in 6.6% (95% confidence interval [CI] 4.6-8.6%) of the 622 girls and women referred and no cancers were detected. Risk for CIN 3 compared to CIN 1 or less included human papillomavirus 16 or 18 (odds ratio [OR] 30.93, 95% CI 6.95-137.65), high-risk, non-16/18 human papillomavirus (OR 6.3, 95% CI 1.3-29.4), and time on oral contraceptives (OR 1.36 per year of use, 95% CI 1.08-1.71).


CONCLUSIONS
Our data support conservative care for adolescents and young women with abnormal cytology since CIN 3 was rare and cervical cancer was never found. Human papillomavirus 16 or 18 was strongly associated with for CIN 3, and testing for these types may be warranted for triage of abnormal cytology in this age group.


METHODS
II.
Moscicki
Anna-Barbara
AB
From the Department of Pediatrics, School of Medicine, University of California, San Francisco; Teenage Clinic, Kaiser Permanente San Francisco; Department of Pathology, University of California, San Francisco; Women's Health Research Institute, Kaiser Permanente Daly City; and Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.
Ma
Yifei
Y
Wibbelsman
Charles
C
Powers
Adaleen
A
Darragh
Teresa M
TM
Farhat
Sepideh
S
Shaber
Ruth
R
Shiboski
Stephen
S
D000293:Adolescent; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D003127:Colposcopy; D005260:Female; D052162:Human papillomavirus 16 / Q000302:isolation & purification*; D052161:Human papillomavirus 18 / Q000302:isolation & purification*; D006801:Humans; D016017:Odds Ratio; D030361:Papillomavirus Infections / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology / Q000821:virology