title: [A prospective study on the prognosis of biopsy-confirmed cervical intraepithelial neoplasia grade 1 and the relationship with high-risk human papillomavirus].
abstract: OBJECTIVE
  To evaluate the prognosis of cervical intraepithelial neoplasia grade 1 (CIN1) at different follow-up time points in Chinese women and the relationship with high-risk human papillomavirus (HR-HPV) infection.
  
  
  METHODS
  Biopsy-confirmed CIN1 women were followed up from cervical cancer screening cohorts established during 1999 to 2008 in Xiangyuan county, Yangcheng county, Qinxian county and Wuxiang county, Shanxi Province.In each follow-up visit, participants were examined by visual inspection with acetic acid, liquid-based cytology and HR-HPV DNA testing. Those with any positive results received colposcope and biopsies. The cumulative incidence rates of CIN grade 2 or worse (CIN2+) and CIN grade 3 or worse (CIN3+), regression rates and persistent rates were calculated using pathological findings as a gold standard. The risks of progression related with HR-HPV were evaluated stratified by baseline and follow-up HR-HPV status.
  
  
  RESULTS
  A total of 228, 224, 261 and 105 CIN1 women received the 1-year, 2-year, 6-year and 11-year follow-up exams, respectively. The cumulative incidence rate of CIN2+ among baseline HR-HPV positive women was 4.8% (6/126), 10.7% (16/150), 16.9% (29/172) and 35% (19/55) in the above follow-up visits, respectively, and their risk of progression was 2.7(95%CI:0.3-22.0), 2.9 (95%CI:0.7-12.1), 12.0 (95%CI:1.7-86.2) and 30.6 (95%CI:1.9-493.5) times higher than baseline HR-HPV negative women. Moreover, the cumulative incidence of CIN2+ among women with positive HR-HPV both at baseline and follow-up visit was 11% (6/55), 14% (6/42), 17% (10/60) and 50% (13/26) in the above follow-up visits, respectively.No new CIN2+ cases were found among those with negative HR-HPV both at baseline and follow-up visits.
  
  
  CONCLUSIONS
  Given that CIN1 progression is related to HR-HPV infection, different follow-up intervals and strategies for CIN1 should be taken according to HR-HPV infection status.
authors.affiliation: Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
authors.forename: Shangying
authors.initials: S
authors.lastname: Hu
authors.affiliation: Email: zhaofangh@cicams.ac.cn.
authors.forename: Fanghui
authors.initials: F
authors.lastname: Zhao
authors.forename: Junfei
authors.initials: J
authors.lastname: Ma
authors.forename: Xinzheng
authors.initials: X
authors.lastname: Wang
authors.forename: Jinxiu
authors.initials: J
authors.lastname: Han
authors.forename: Aimei
authors.initials: A
authors.lastname: Li
authors.forename: Feng
authors.initials: F
authors.lastname: Chen
authors.forename: Xun
authors.initials: X
authors.lastname: Zhang
authors.forename: Qinjing
authors.initials: Q
authors.lastname: Pan
authors.forename: Youlin
authors.initials: Y
authors.lastname: Qiao
mesh_terms: D000368:Aged; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D006801:Humans; D030361:Papillomavirus Infections; D011379:Prognosis; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms; D002578:Uterine Cervical Dysplasia