High long-term cure rate justifies routine treatment of cervical intraepithelial neoplasia grade I

The long-term clearance of cervical intraepithelial neoplasia (CIN) Grade 1 after one treatment was studied retrospectively in 105 patients. Treatment was by CO2 laser vaporization (74 patients), cone biopsy (8), loop electroexcision (LEEP) (7), electrodiathermy (1) and hysterectomy (2); 79 of the 92 treated patients (85.9%) had normal cervical cytology and colposcopy on a mean follow-up period of 36.7 months (95% confidence interval between 33.1-40.4 months). Life table analysis showed that the probability of the cervix remaining disease free was 81% at 72 months of follow-up. Of the 13 patients with a cervical abnormality after the initial treatment, 4 had persistent CIN 1, 3 persistent human papillomavirus (HPV) infection, 2 recurrent CIN 1 and 4 had recurrent HPV infection. In contrast, of the 13 untreated patients with CIN 1, 7 (53.8%) continued to demonstrate an abnormality on the cervix after a mean follow-up period of 27.5 months (95% confidence interval between 18.8 and 36.3 months). No significant perioperative morbidity was recorded in the treated patients. The results of this study suggest that CIN 1 can be effectively eradicated in more than 80% of women with 1 treatment alone. The treatment should be considered for all these patients to spare them the psychological and emotional trauma of having to face repeated abnormal cervical cytology on follow up.