title: Natural history of histologically moderate cervical dysplasia in adolescent and young women.
abstract: BACKGROUND
  Adolescent women are a special age group affected by human papilloma virus (HPV). Most guidelines recommend surgical treatment for high-grade cytological lesions. However, some reports have attempted to demonstrate that the immune system is fully capable of clearing the virus without using conization. Our aim in this study was to describe the outcome of women <25 years old with high-grade cytology pap smears and no histologically confirmed cervical intraepithelial neoplasm [CIN] III.
  
  
  METHODS
  This prospective cohort study, carried out at the Department of Obstetrics and Gynecology, Hospital 12 de Octubre, included 29 women aged 25 years or younger with high-grade cytological lesions recruited in screening programs and were followed up at 15 months. This study describes the clinical course of the women, and we determined the percentage of cytological, histological, and microbiological lesions produced by HPV that were cleared without surgical treatment in these women during their follow-up.
  
  
  RESULTS
  During follow-up, 63% of high-grade cytological lesions and all high-grade histological lesions were cleared. HPV was eliminated from 23% of patients with one HPV serotype and 27% with multiple HPV serotypes without any treatment.
  
  
  CONCLUSIONS
  These results suggest that there is no need to use surgical treatment to clear high-grade cytological and cervical lesions in adolescent women, thus preventing damage to their reproductive future.
authors.affiliation: Gynecologic Oncology Service, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Piris
authors.affiliation: Gynecologic Oncology Service, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Victoria
authors.initials: V
authors.lastname: Bravo
authors.affiliation: Gynecologic Oncology Service, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Alvarez
authors.affiliation: Gynecologic Oncology Service, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Leticia
authors.initials: L
authors.lastname: Muñoz-Hernando
authors.affiliation: Gynecologic Oncology Service, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Estela
authors.initials: E
authors.lastname: Lorenzo-Hernando
authors.affiliation: Gynecologic Oncology Service, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Reyes
authors.initials: R
authors.lastname: Oliver
authors.affiliation: Gynecologic Oncology Service, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Marqueta-Marques
authors.affiliation: Gynecologic Oncology Service, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Seoane-Ruiz
authors.affiliation: Gynecologic Oncology Service, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Tejerizo-Garcia
authors.affiliation: Gynecologic Oncology Service, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Jesús S
authors.initials: JS
authors.lastname: Jiménez
keywords: cervical intraepithelial neoplasia; conservative management; human papilloma virus