title: Recurrence of high-grade cervical abnormalities following conservative management of cervical intraepithelial neoplasia grade 2.
abstract: OBJECTIVE
  Conservative management of cervical intraepithelial neoplasia (CIN) grade 2 in women younger than 25 years may reduce overtreatment. However, long-term efficacy remains uncertain. This retrospective cohort study aimed to determine the rate of recurrence of high-grade abnormalities among young women with a history of CIN 2 that spontaneously regressed within 2 years and compare this with the rate of high-grade abnormality in similar women with an initial diagnosis of CIN 1.
  
  
  METHODS
  We identified all women aged younger than 25 years who were diagnosed with CIN 1 or CIN 2 between January 2005 and August 2009 within 2 colposcopy units. Follow-up data from the National Cervical Screening Programme were obtained to identify those women who developed recurrent high-grade lesions before October 2012. Comparisons were made using Cox proportional hazards regression.
  
  
  RESULTS
  A total of 683 women were included: 106 with CIN 2 that spontaneously regressed, 299 with treated CIN 2, and 278 with conservatively managed CIN 1. Median follow-up was 4 years. There was no significant difference in the risk of development of high-grade abnormalities after 2 years between the spontaneously regressing CIN 2 and CIN 1 groups (P = .83). Women with treated CIN 2 had a significantly lower risk of recurrence than women with untreated CIN 2 (P = .01).
  
  
  CONCLUSIONS
  CIN 2 that has spontaneously regressed appears to behave as a low-grade lesion. This study contributes to the growing body of evidence that careful observation of CIN 2 is an efficacious and appropriate initial management option for women aged younger than 25 years at diagnosis.
authors.affiliation: Department of Obstetrics and Gynecology, University of Otago Christchurch, Christchurch, New Zealand. Electronic address: wilth689@student.otago.ac.nz.
authors.forename: Tom M
authors.initials: TM
authors.lastname: Wilkinson
authors.affiliation: Department of Obstetrics and Gynecology, University of Otago Christchurch, Christchurch, New Zealand.
authors.forename: Peter H H
authors.initials: PH
authors.lastname: Sykes
authors.affiliation: Department of Obstetrics and Gynecology, University of Otago Christchurch, Christchurch, New Zealand.
authors.forename: Bryony
authors.initials: B
authors.lastname: Simcock
authors.affiliation: Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Simone
authors.initials: S
authors.lastname: Petrich
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D005260:Female; D006801:Humans; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*
keywords: cervical intraepithelial neoplasia; conservative management; grade 2; young women