title: Outcomes after management of young women with cervical intraepithelial neoplasia 2 with a 6-month observation protocol.
abstract: OBJECTIVE
  Recommendations regarding treatment of cervical intraepithelial neoplasia (CIN) 2 in women have evolved over the years: young women with CIN 2 may be offered observation with Pap smears and colposcopy every 6 months instead of immediate excision or ablation of disease. The purpose of this study was to observe patient follow-up during the initiation of this management protocol for young women with CIN 2.
  
  
  METHODS
  This was a retrospective review of clinical outcomes of women younger than 30 years with CIN 2 on index biopsy and planned follow-up at UNC between July 2009 and August 2010. A chart review for clinical variables, follow-up visits, and progression of disease was conducted. Primary analysis determined the rate of follow-up and pathology at 6 months. Secondary analysis investigated risk factors for incomplete follow-up.
  
  
  RESULTS
  Seventy women met inclusion criteria; 46 were managed with observation. Twenty-eight (60.8%; 28/46) women completed a follow-up visit. Demographic and clinical variables did not reach statistical significance in predicting the likelihood of completion of a follow-up visit, although there was a trend toward greater follow-up in employed patients (odds ratio = 5.25, 95% confidence interval = 0.84-34.78). Approximately half (52.4%; 11/21) of women with a completed cervical biopsy demonstrated regression of disease during the study period.
  
  
  CONCLUSIONS
  On the basis of these data, follow-up in this population was unpredictable based on basic demographic or clinical factors that we often use to judge likelihood of compliance with medical recommendations. The percentage of patients with regression at follow-up was as expected from the natural history of CIN 2.
authors: Departments of 1Obstetrics and Gynecology, 2Biostatistics, 3Epidemiology, and 4Pathology, University of North Carolina, Chapel Hill, NC.
authors: Elizabeth
authors: E
authors: Bleecker
authors: Elizabeth
authors: E
authors: Koehler
authors: Jennifer
authors: J
authors: Smith
authors: Debra
authors: D
authors: Budwit
authors: Lisa
authors: L
authors: Rahangdale
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D005260:Female; D006302:Health Services Research; D006651:Histocytochemistry; D006801:Humans; D019370:Observation / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology*