History of Surgical Treatment for Cervical Intraepithelial Neoplasia

Purpose The aim of this study was to determine the risk of human papillomavirus (HPV)–related carcinomas and premalignancies in women diagnosed with cervical intraepithelial neoplasia grade 3 (CIN3). Knowledge of this risk is important to preventing the development and progression of other HPV-related premalignancies and carcinomas, by considering prophylactic HPV vaccination and/or by paying increased attention to other HPV-related carcinomas and premalignancies when CIN3 is identified. Methods Women diagnosed with a CIN3 between 1990 and 2010 were identified from the Dutch nationwide registry of histopathology and cytopathology (PALGA) and matched with a control group of women without CIN3. Subsequently, all cases of high-risk (hr) HPV–associated high-grade lesions and carcinomas in the anogenital region and oropharynx between 1990 and 2015 were extracted. Incidence rate ratios were estimated for carcinomas and premalignancies of the vulva, vagina, anus, and oropharynx. Results A total of 178,036 women were identified: 89,018 with a previous diagnosis of CIN3 and 89,018 matched control subjects without a history of CIN3. Women with a history of CIN3 showed increased risk of HPV-related carcinomas and premalignancies, with incidence rate ratios of 3.85 (95% CI, 2.32 to 6.37) for anal cancer, 6.68 (95% CI, 3.64 to 12.25) for anal intraepithelial neoplasia grade 3, 4.97 (95% CI, 3.26 to 7.57) for vulvar cancer, 13.66 (93% CI, 9.69 to 19.25) for vulvar intraepithelial neoplasia grade 3, 86.08 (95% CI, 11.98 to 618.08) for vaginal cancer, 25.65 (95% CI, 10.50 to 62.69) for vaginal intraepithelial neoplasia grade 3, and 5.51 (95% CI, 1.22 to 24.84) for oropharyngeal cancer. This risk remained significantly increased, even after long-term follow-up of up to 20 years. Conclusion This population-based study shows a long-lasting increased risk for HPV-related carcinomas and premalignancies of the anogenital and oropharyngeal region after a CIN3 diagnosis. Studies that investigate methods to prevent this increased risk in this group of patients, such as intensified screening or vaccination, are warranted.

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Preterm Delivery After Surgical Treatment for Cervical Intraepithelial Neoplasia

Obstetrics and Gynecology ◽

10.1097/01.aog.0000253239.87040.23 ◽

2007 ◽

Vol 109 (2, Part 1) ◽

pp. 309-313 ◽

Cited By ~ 99

Author(s):

Maija Jakobsson ◽

Mika Gissler ◽

Susanna Sainio ◽

Jorma Paavonen ◽

Anna-Maija Tapper

Keyword(s):

Surgical Treatment ◽

Cervical Intraepithelial Neoplasia ◽

Preterm Delivery ◽

Intraepithelial Neoplasia

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Natural History of Cervical Intraepithelial Neoplasia 1 in Primigravida

Journal of Lower Genital Tract Disease ◽

10.1097/00128360-200301000-00007 ◽

2003 ◽

Vol 7 (1) ◽

pp. 29-31 ◽

Cited By ~ 1

Author(s):

Gary Ventolini ◽

Ralph Samlowski

Keyword(s):

Natural History ◽

Cervical Intraepithelial Neoplasia ◽

Intraepithelial Neoplasia ◽

History Of

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Natural history of cervical intraepithelial neoplasia in pregnancy: postpartum histo-pathologic outcome and review of the literature

BMC Pregnancy and Childbirth ◽

10.1186/s12884-016-0861-8 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 17

Author(s):

Mariella Mailath-Pokorny ◽

Richard Schwameis ◽

Christoph Grimm ◽

Alexander Reinthaller ◽

Stephan Polterauer

Keyword(s):

Natural History ◽

Cervical Intraepithelial Neoplasia ◽

Intraepithelial Neoplasia ◽

Review Of The Literature ◽

History Of ◽

In Pregnancy

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Natural history of histologically confirmed high-grade cervical intraepithelial neoplasia during pregnancy: meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-048055 ◽

2021 ◽

Vol 11 (8) ◽

pp. e048055

Author(s):

Cheng Chen ◽

Yu Xu ◽

Wu Huang ◽

Yi Du ◽

Cui Hu

Keyword(s):

Natural History ◽

Cervical Intraepithelial Neoplasia ◽

Meta Analysis ◽

Intraepithelial Neoplasia ◽

Progression Rate ◽

Lower Grade ◽

High Grade ◽

Regression Rate ◽

Persistence Rate ◽

History Of

ObjectivesThis study aimed to conduct a meta-analysis of estimates of the natural history of high-grade cervical intraepithelial neoplasia (CIN) during pregnancy.SettingStudies examining the clinical courses of histologically confirmed high-grade CIN during pregnancy.ParticipantsWe searched PubMed, Web of Science and Embase for eligible studies. Studies were included if they reported the data regarding the natural history of histologically confirmed high-grade CIN during pregnancy. Final estimates were from the meta-analysis of 10 eligible studies.Primary outcome measuresThe regression rate, persistence rate and progression rate of histologically proven untreated high-grade CIN during pregnancy.ResultsA total of 10 original studies were included in this meta-analysis. During pregnancy, the regression rate, persistence rate and progression rate of high-grade CIN were 40% (95% CI 35% to 45%), 59% (95% CI 54% to 64%) and 1% (95% CI 0% to 2%), respectively. There was moderate heterogeneity among the studies. The results of the subgroup meta-analysis show that the pooled rates of regression and persistence during pregnancy were 59% (95% CI 54% to 65%) and 40% (95% CI 35% to 45%) for CIN2, and 29% (95% CI 25% to 33%) and 70% (95% CI 65% to 73%) for CIN3.ConclusionsDuring pregnancy, the majority of histologically confirmed high-grade CIN would be persistent or regressed to lower grade CIN or normal. However, it is still worth noting that a small percentage of high-grade CIN would progress to cervical cancer during pregnancy.

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NATURAL HISTORY OF CERVICAL INTRAEPITHELIAL NEOPLASIA GRADE 2 UNDER ACTIVE SURVEILLANCE – A SYSTEMATIC REVIEW AND META-ANALYSIS

10.26226/morressier.599bdc79d462b80296ca0d36 ◽

2017 ◽

Author(s):

Karoliina Tainio

Keyword(s):

Systematic Review ◽

Natural History ◽

Cervical Intraepithelial Neoplasia ◽

Active Surveillance ◽

Meta Analysis ◽

Intraepithelial Neoplasia ◽

Cervical Intraepithelial Neoplasia Grade ◽

History Of

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Natural History of Grade 1 Cervical Intraepithelial Neoplasia in Women With Human Immunodeficiency Virus

Obstetrics and Gynecology ◽

10.1097/01.aog.0000143256.63961.c0 ◽

2004 ◽

Vol 104 (5, Part 1) ◽

pp. 1077-1085 ◽

Cited By ~ 26

Author(s):

L Stewart Massad ◽

Charlesnika T. Evans ◽

Howard Minkoff ◽

D Heather Watts ◽

Howard D. Strickler ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Natural History ◽

Cervical Intraepithelial Neoplasia ◽

Intraepithelial Neoplasia ◽

Immunodeficiency Virus ◽

History Of

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Difference in prevalence of human papillomavirus genotypes in cytomorphologically normal cervical smears is associated with a history of cervical intraepithelial neoplasia

International Journal of Cancer ◽

10.1002/ijc.2910480317 ◽

1991 ◽

Vol 48 (3) ◽

pp. 404-408 ◽

Cited By ~ 83

Author(s):

Adriaan J. C. Van Den Brule ◽

Jan M. M. Walboomers ◽

Marc Du Maine ◽

Peter Kenemans ◽

Chris J. L. M. Meijer

Keyword(s):

Human Papillomavirus ◽

Cervical Intraepithelial Neoplasia ◽

Intraepithelial Neoplasia ◽

Cervical Smears ◽

History Of

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Prophylactic human papillomavirus vaccination to prevent recurrence of cervical intraepithelial neoplasia: a meta-analysis

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2020-001197 ◽

2020 ◽

Vol 30 (6) ◽

pp. 777-782 ◽

Cited By ~ 2

Author(s):

Helena C Bartels ◽

James Postle ◽

Ailin C Rogers ◽

Donal Brennan

Keyword(s):

Human Papillomavirus ◽

Surgical Treatment ◽

Cervical Intraepithelial Neoplasia ◽

Systematic Reviews ◽

Literature Search ◽

Meta Analysis ◽

Hpv Vaccination ◽

Intraepithelial Neoplasia ◽

Number Needed To Treat ◽

Risk Of Recurrence

ObjectiveThe aim of this systematic review and meta-analysis was to review evidence supporting the use of prophylactic human papillomavirus (HPV) vaccines to influence the risk of recurrence of cervical intraepithelial neoplasia after surgical treatment.MethodsA systematic literature search was performed for publications reporting risk of recurrence of cervical intraepithelial neoplasia after surgical treatment in patients receiving HPV vaccination (either in the prophylactic or adjuvant setting). Comprehensive searches of six electronic databases (MEDLINE, Embase, Web of Science, PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and references of identified studies) from their inceptions were performed (English language only), and hand search reference lists were performed. Two independent reviewers applied inclusion and exclusion criteria to select manuscripts, with differences discussed and agreed by consensus. The literature search was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results were reported as mean differences or pooled odds ratios (OR) with 95% confidence intervals (95% CI).ResultsA total of 5744 citations were reviewed; 5 studies comprising 2912 patients were selected for the analysis. There were 1338 patients in the vaccinated group and 1574 in the placebo or unvaccinated group. The incidence of histologically confirmed cervical intraepithelial neoplasia 2+ was reduced in the vaccinated compared to the unvaccinated group (OR 0.34, 95% CI 0.21–0.54, p=< 0.00001). The number needed to treat to prevent one recurrence was 27. Both pre-treatment vaccination (OR 0.40, 95% CI 0.21–0.78, p=0.007, number needed to treat – 37) and adjuvant vaccination (OR 0.28, 95% CI 0.14–0.56, p=0.0003, number needed to treat – 30) reduced recurrence rates.ConclusionProphylactic or adjuvant HPV vaccination reduces the risk of recurrent cervical intraepithelial neoplasia 2+. These data support further investigation of its role as an adjuvant to surgical treatment.

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