title: Rate of and risks for regression of cervical intraepithelial neoplasia 2 in adolescents and young women.
abstract: OBJECTIVE
  To describe the natural history of cervical intraepithelial neoplasia (CIN) 2 in a prospective study of adolescents and young women, and to examine the behavioral and biologic factors associated with regression and progression.
  
  
  METHODS
  Adolescents and women aged 13 to 24 years who were referred for abnormal cytology and were found to have CIN 2 on histology were evaluated at 4-month intervals. Risks for regression were defined as three consecutive negative cytology and histology visits, and progression to CIN 3 was estimated using Cox proportional hazards regression models.
  
  
  RESULTS
  Ninety-five patients with a mean age of 20.4 years (±2.3) were entered into the analysis. Thirty-eight percent resolved by year 1, 63% resolved by year 2, and 68% resolved by year 3. Multivariable analysis found that recent Neisseria gonorrhoeae infection (hazard ratio 25.27; 95% confidence interval [CI] 3.11-205.42) and medroxyprogesterone acetate use (per month) (hazard ratio 1.02; 95% CI 1.003-1.04) were associated with regression. Factors associated with nonregression included combined hormonal contraception use (per month) (hazard ratio 0.85; 95% CI 0.75-0.97) and persistence of human papillomavirus (HPV) of any type (hazard ratio 0.40; 95% CI 0.22-0.72). Fifteen percent of patients showed progression by year 3. HPV 16/18 persistence (hazard ratio 25.27; 95% CI 2.65-241.2; P=.005) and HPV 16/18 status at last visit (hazard ratio 7.25; 95% CI 1.07-49.36; P<.05) were associated with progression Because of the small sample size, other covariates were not examined.
  
  
  CONCLUSIONS
  The high regression rate of CIN 2 supports clinical observation of this lesion in adolescents and young women.
authors.affiliation: From the Department of Pediatrics, School of Medicine, University of California, San Francisco, California; the Teenage Clinic, Kaiser Permanente, San Francisco, California; the Department of Pathology, University of California, San Francisco, California; and the Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
authors.forename: Anna-Barbara
authors.initials: AB
authors.lastname: Moscicki
authors.forename: Yifei
authors.initials: Y
authors.lastname: Ma
authors.forename: Charles
authors.initials: C
authors.lastname: Wibbelsman
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Darragh
authors.forename: Adaleen
authors.initials: A
authors.lastname: Powers
authors.forename: Sepideh
authors.initials: S
authors.lastname: Farhat
authors.forename: Stephen
authors.initials: S
authors.lastname: Shiboski
mesh_terms: D000293:Adolescent; D018450:Disease Progression; D005260:Female; D006801:Humans; D009365:Neoplasm Regression, Spontaneous; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications* / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000821:virology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000821:virology