title: Spontaneous regression of CIN2 in women aged 18-24 years: a retrospective study of a state-wide population in Western Australia.
abstract: BACKGROUND
  CIN2 has a high rate of spontaneous regression in young women and may be managed conservatively in appropriately selected patients. This study aimed to investigate health outcomes in women aged 18-24 years with biopsy-confirmed CIN2.
  
  
  METHODS
  A retrospective cohort study of Western Australian women aged 18-24 years diagnosed with CIN2 on cervical biopsy from 1 January 2001 to 31 December 2010. Women who had not received treatment at ≥4 months following CIN2 diagnosis were classified as managed 'conservatively'. Subsequent cervical cytology and/or biopsy test results were used to report lesion regression (absence of dysplasia or an epithelial lesion of lower grade than CIN2) and disease persistence (CIN2, CIN3 or ACIS).
  
  
  RESULTS
  Follow-up data were available for 2417 women of whom 924 (38.2%) were 'conservatively' managed. In all, 152 (16.4%) conservatively managed women had a lesion more severe than CIN2 detected within 24 months of initial diagnosis, of which 144 were CIN3 and eight were ACIS. There was no statistically significant association between rates of regression and patient age, Socio-economic Indexes for Areas or Accessibility/Remoteness Index of Australia indices. The 2-year regression rate for CIN2 was estimated to be 59.5% (95%CI 0.5-0.6) in this cohort of women.
  
  
  CONCLUSIONS
  In conservatively managed young women with CIN2 there was a high rate of spontaneous disease regression. Thus, excisional or ablative treatments may be avoided in selected patients who receive appropriate counseling and who are able to comply with more intensive and prolonged follow-up requirements.
authors.affiliation: Institute of Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.|St John of God Hospital Bendat Family Comprehensive Cancer Centre, Subiaco, WA, Australia.|Centre for Population Health Research, Curtin University, Bentley, WA, Australia.
authors.forename: Aime
authors.identifier: http://orcid.org/0000-0002-3338-1044
authors.initials: A
authors.lastname: Munro
authors.affiliation: Centre for Population Health Research, Curtin University, Bentley, WA, Australia.|School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia.
authors.forename: Rhys G
authors.identifier: http://orcid.org/0000-0002-8951-8572
authors.initials: RG
authors.lastname: Powell
authors.affiliation: Institute of Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.|St John of God Hospital Bendat Family Comprehensive Cancer Centre, Subiaco, WA, Australia.|School of Women's and Infants' Health Research, University of Western Australia, Crawley, WA, Australia.
authors.forename: Paul
authors.identifier: http://orcid.org/0000-0002-4860-9232
authors.initials: P
authors.lastname: A Cohen
authors.affiliation: School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia.
authors.forename: Shirley
authors.identifier: http://orcid.org/0000-0003-3268-3232
authors.initials: S
authors.lastname: Bowen
authors.affiliation: Centre for Population Health Research, Curtin University, Bentley, WA, Australia.
authors.forename: Katrina
authors.identifier: http://orcid.org/0000-0002-7434-2957
authors.initials: K
authors.lastname: Spilsbury
authors.affiliation: Faculty of Health Science, Curtin University, Bentley, WA, Australia.
authors.forename: Peter
authors.identifier: http://orcid.org/0000-0001-9375-0801
authors.initials: P
authors.lastname: O'Leary
authors.affiliation: Centre for Population Health Research, Curtin University, Bentley, WA, Australia.
authors.forename: James B
authors.identifier: http://orcid.org/0000-0003-2744-1394
authors.initials: JB
authors.lastname: Semmens
authors.affiliation: Institute of Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.
authors.forename: Jim
authors.identifier: http://orcid.org/0000-0001-7924-1357
authors.initials: J
authors.lastname: Codde
authors.affiliation: School of Biomedical Sciences, Curtin University, Bentley, WA, Australia.
authors.forename: Vincent
authors.identifier: http://orcid.org/0000-0003-3807-8121
authors.initials: V
authors.lastname: Williams
authors.affiliation: WA Cervical Cancer Prevention Program, Perth, WA.
authors.forename: Nerida
authors.identifier: http://orcid.org/0000-0002-6601-7310
authors.initials: N
authors.lastname: Steel
authors.affiliation: School of Women's and Infants' Health Research, University of Western Australia, Crawley, WA, Australia.
authors.forename: Yee
authors.identifier: http://orcid.org/0000-0003-0349-8652
authors.initials: Y
authors.lastname: Leung
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000293:Adolescent; D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D060787:Neoplasm Grading; D009365:Neoplasm Regression, Spontaneous; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000628:therapy; D057832:Watchful Waiting; D014904:Western Australia; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000628:therapy
keywords: CIN; Cervical abnormality; cervical dysplasia; pre-invasive; squamous; young women