Causes and management of cervical intraepithelial neoplasia

The evidence for human papillomavirus (HPV) playing a role in the pathogenesis of lower genital neoplasia is reviewed. It is likely that this group of viruses is etiologically important. It is suggested that cervical lesions be diagnosed as flat condyloma if they contain HPV types six or 11 and as cervical intraepithelial neoplasia (CIN) if they are confined to the epithelium and contain HPV Types 16 or 18 or other types associated with neoplasia. Patients with a Papanicolaou (PAP) smear or clinical evidence of HPV infection in the genital tract should be examined colposcopically, invasive cancer should be excluded, and the HPV-induced lesions should be identified and eradicated.