Assessment and management of cervical intraepithelial neoplasia

Although cervical intraepithelial neoplasia (CIN) once was thought to be a clinical problem primarily for older women, data reveal an alarming rise of this condition among younger women. The gains made in decreasing the incidence of cervical cancer have been tempered by the steadily increasing incidence of its precursor state, CIN. Because of increasing evidence of the association of the human papillomavirus (HPV) with cervical cancer and CIN, this virus is of particular concern. Colposcopy is a valuable method for evaluating CIN that has been indicated on Pap, as well as for identifying HPV. Since having an abnormal Pap and undergoing colposcopic examination may be stressful, the clinician can play a significant role in helping the client cope with the process of evaluation and treatment of abnormal Paps in addition to controlling cervical cancer.