[Cervical intraepithelial neoplasia: an attempt to propose rules for good medical practice]

The authors emphasize the advantages of the term "cervical intraepithelial neoplasia" (CIN) over "dysplasia" and "carcinoma-in-situ". The rules for good medical practice in treating CIN are based on several starting points, namely: proven role of the human papillomavirus (HPV) in the development of CIN; current possibilities to diagnose and to prevent HPV infections; morphological stigmata of CIN within the epithelium; possibilities to treat CIN and lack of possibilities to treat HPV infection; assessment of the patient 's reproductive potential. In recent cases of CIN1 the history of anti-HPV vaccination is an important factor in choosing the best treatment protocol. In cases of persistent CIN1 treatment protocols are influenced by the presence/absence of high-risk types of HPV. In recent cases of CIN2 treatment protocols vary according to the extent of the lesion, as well as its penetration within the cervical canal. The latter sign is of foremost importance in recent cases of CIN3. Treatment protocols for all the above mentioned conditions, for persistent CIN2 and CIN3,as well as for post-treatment recurrences are presented in flow chart form. Patients' age and reproductive potential should be taken into consideration in selected cases of CIN2+. CIN in pregnant patients deserves a more conservative approach.