Management of Colposcopy Patients with Biopsy-Proven Cervical Intraepithelial Neoplasia Grade 1

Objective. Our goal was to evaluate, using a retrospective cohort study design, the management and outcome of 403 women with a colposcopic biopsy of cervical intraepithelial neoplasia grade 1 (CIN1). Methods. Patients were identified from a database of 3,782 new colposcopy patients from 1990 to 1996. CIN1 on initial biopsy was identified in 505 women, and inclusion criteria were met by 403. Management and follow-up information was retrieved from the colposcopy record and computerized pathology information system. Results. Management consisted of immediate treatment for 112 women (cone biopsy, 4; cryotherapy, 26; laser ablation, 79; loop electrosurgical excision, 3) and follow-up for 291 women (colposcopy follow-up, 192; cytology follow-up by family doctor, 99). In patients with a CIN1 biopsy and an index Papanicolaou smear no more serious than atypia, 78% had follow-up only. If the index cytology showed CIN1, 51% had immediate treatment. Conclusion. Conservative management of patients with biopsy-proven CIN1 appears to be appropriate, as 64.6% of patients with follow-up reverted to benign cytology. However, compliance with follow-up must be ensured, as the failure rate of immediate treatment is not insignificant at 21%.