Choosing Wisely:

Avoid treatment of CIN 1 in women under age 25.

Rationale and Comments: Regardless of prior cytology, treatment of CIN 1 in women aged 21– to 4 years is not recommended. CIN 1 is the histologic manifestation of HPV infection, and like HPV infection in young women, regression rates are high. It is uncommon for these lesions to progress.
Sponsoring Organizations:
  • American Society for Colposcopy and Cervical Pathology
  • Sources:
  • Prospective cohort studies
  • Disciplines:
  • Gynecologic
  • Preventive Medicine
  • Oncologic
  • References: • Massad LS, Einstein MH, Huh WK, Katki HA, Kinney WK, et al. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstet Gynecol. 2013;121:829-46.
    • Moscicki AB, Shiboski S, Hills NK, Powell KJ, Jay N, Hanson EN, et al. Regression of low-grade squamous intraepithelial lesions in young women. Lancet. 2004;364:1678-83.
    • Cox JT, Schiffman M, Solomon D. Prospective follow-up suggests similar risk of subsequent cervical intraepithelial neoplasia grade 2 or 3 among women with cervical intraepithelial neoplasia grade 1 or negative colposcopy and directed biopsy. Am J Obstet Gynecol. 2003;188:1406-12.

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