Follow up in women with biopsy diagnosis of cervical low-grade squamous intraepithelial lesion (LSIL): how long should it be?

Arch Gynecol Obstet. 2017 Apr;295(4):997-1003. doi: 10.1007/s00404-017-4335-7. Epub 2017 Mar 3.

Abstract

Aim: To analyse the regression rate and the risk of persistence or progression of the lesions in women with a histopathological diagnosis of cervical low-grade squamous intraepithelial lesion (LSIL).

Materials and methods: Retrospective cohort study of women with biopsy diagnosis of cervical LSIL, from January 2010 to December 2013. After the initial diagnosis of LSIL, all the women underwent scheduled follow-up examinations with cytology every 6 months for 2 years and an HPV test after 1 year.

Results: At the 24 -month follow-up, the regression of cervical LSIL was observed in 88.5% of the women. 10.8% of the women had a persistent lesion, while a progression towards cervical HSIL was reported in 0.7% of the women. The risk of persistence or progression of histological LSIL was higher in women with ASC-H or HSIL on the referral cytology and in tobacco users.

Conclusion: In women with biopsy diagnosis of cervical LSIL, preceded by ASCUS or LSIL on cytology, a high rate of regression was observed and, in most of the cases, the regression occurred in the first year of follow-up. In women with cervical LSIL, preceded by ASC-H or HSIL on cytology, and in tobacco users, a higher risk of persistence and progression was observed. Thus, in these cases, repeated follow-up examinations, even with the HR-HPV test, are advisable.

Keywords: CIN1; Cervical intraepithelial neoplasia; Follow-up; LSIL; Persistence; Regression.

MeSH terms

  • Adult
  • Biopsy
  • Clinical Protocols
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Smoking
  • Squamous Intraepithelial Lesions of the Cervix / pathology*
  • Time Factors
  • Uterine Cervical Dysplasia / pathology*
  • Uterine Cervical Neoplasms / pathology*
  • Vaginal Smears
  • Young Adult