title: Colposcopy prediction of progression in human papillomavirus infections with minor cervical lesions.
abstract: OBJECTIVE
  To evaluate the risk of progression to cervical intraepithelial neoplasia (CIN) grade 2 or 3 in women with positive human papillomavirus (HPV) testing and low-grade (low-grade squamous intraepithelial lesions), borderline (atypical squamous cells of undetermined significance), or no cervical lesions, and to determine the accuracy of initial colposcopy to predict progression.
  
  
  METHODS
  Women with HPV infection and low-grade squamous intraepithelial lesions, atypical squamous cells, or normal cytology were recruited and grouped according to cytologic or histologic diagnosis. Exclusion criteria were histologic CIN 2 or 3, previous cervical cancer and HPV infection, cervical disease, or treatment for CIN 2 or 3 in the past 3 years. Four-hundred sixty-five women were included and monitored by cytology, Hybrid Capture-2 test, and colposcopy every 6 months. Colposcopy results were described as normal, with minor or major changes, and lesion size was recorded in quadrants.
  
  
  RESULTS
  Forty-three women (9.3%) had progression to CIN 2 or 3. No significant differences were found in rate of progression between women with low-grade squamous intraepithelial lesions, atypical squamous cells, or negative results (8.2%, 13.4%, and 9.8%, respectively; P=.679). Neither colposcopy pattern (P=.284) nor lesion size (P=.170) at recruitment provided any information on the risk of progression. History of cervical lesion and worsening of the colposcopy pattern during follow-up were associated with progression (P<.001).
  
  
  CONCLUSIONS
  Initial colposcopy findings do not provide relevant information on the risk of progression in HPV-positive women with minor or no cervical lesions. These women have a similar risk of progression and should benefit from the same follow-up strategies.
authors.affiliation: From the Department of Obstetrics and Gynecology, IDIBAPS-Hospital Clínic, University of Barcelona, Faculty of Medicine, Barcelona, Spain; and the Department of Pathology, CRESIB-Hospital Clínic, University of Barcelona Faculty of Medicine, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Del Pino
authors.forename: Aureli
authors.initials: A
authors.lastname: Torne
authors.forename: Immaculada
authors.initials: I
authors.lastname: Alonso
authors.forename: Raquel
authors.initials: R
authors.lastname: Mula
authors.forename: Narcís
authors.initials: N
authors.lastname: Masoller
authors.forename: Victoria
authors.initials: V
authors.lastname: Fuste
authors.forename: Jaume
authors.initials: J
authors.lastname: Ordi
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy; D018450:Disease Progression; D005260:Female; D006801:Humans; D030361:Papillomavirus Infections / Q000150:complications*; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000821:virology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000821:virology*