Can We Reduce Overtreatment of Cervical High-Grade Squamous Intraepithelial Lesions?

Objective The aim was to evaluate the cytology, colposcopic, and pathological factors associated with the absence of high-grade squamous intraepithelial lesion (HSIL)/cervical intraepithelial neoplasia (CIN) 2–3 lesion on loop electrosurgical excision procedure (LEEP) specimens in women with high-grade cytology and/or HSIL/CIN 2–3 biopsy and the risk of disease persistence/recurrence. Materials and Methods Two-center retrospective study of women undergoing LEEP for high-grade cervical disease between January 2014 and December 2019. Clinical, cytology, colposcopy, and pathology results were evaluated to identify independent predictive factors associated with CIN 1/negative LEEP results. Univariate and multivariate logistic regression models were performed. Follow-up data was evaluated to assess the risk of HSIL/CIN 2–3 persistence/recurrence. Results Six hundred thirty-nine of 801 women (79.8%) had high-grade cytology and 631 (78.8%) HSIL/CIN 2–3 biopsy. High-risk human papillomavirus test was positive in 98% of women. Loop electrosurgical excision procedure specimen showing CIN 1 or less was found in 27%–31%. Normal/low-grade colposcopy (odds ratio [OR] = 2.17, CI = 1.39–3.39, p = .001) and CIN 1/negative biopsy (OR = 3.25, CI = 2.12–4.99, p
Source: Journal of Lower Genital Tract Disease - Category: OBGYN Tags: HPV Associated Disease Source Type: research