Subsequent risks for cervical precancer and cancer in women with low-grade squamous intraepithelial lesions unconfirmed by colposcopy-directed biopsy

Results from a multicenter, prospective, cohort study

Koji Matsumoto, Yasuo Hirai, Reiko Furuta, Naoyoshi Takatsuka, Akinori Oki, Toshiharu Yasugi, Hiroo Maeda, Akira Mitsuhashi, Takuma Fujii, Kei Kawana, Tsuyoshi Iwasaka, Nobuo Yaegashi, Yoh Watanabe, Yutaka Nagai, Tomoyuki Kitagawa, Hiroyuki Yoshikawa

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective To investigate the natural course of low-grade squamous intraepithelial lesions (LSILs) that cannot be histologically confirmed by colposcopy-directed biopsy. Methods In a multicenter, prospective, cohort study of Japanese women with LSILs, we analyzed the follow-up data from 64 women who had a negative biopsy result at the initial colposcopy (biopsy-negative LSIL) in comparison with those from 479 women who had a histologic diagnosis of cervical intraepithelial neoplasia grade 1 (LSIL/CIN1). Patients were monitored by cytology and colposcopy every 4 months for a mean follow-up period of 39.0 months, with cytologic regression defined as two consecutive negative smears and normal colposcopy. Results In women with biopsy-negative LSILs, there were no cases of CIN3 or worse (CIN3+) diagnosed within 2 years; the difference in the 2-year risk of CIN3+ between the two groups was marginally significant (0 vs. 5.5%; P = 0.07). The cumulative probability of cytologic regression within 12 months was much higher in the biopsynegative LSIL group (71.2 vs. 48.6%; P = 0.0001). The percentage of women positive for high-risk human papillomaviruses (hrHPVs) was significantly lower in the biopsynegative LSIL group than in the LSIL/CIN1 group (62.1 vs. 78.4%; P = 0.01); however, the 12-month regression rate of biopsy-negative LSIL was similar between hrHPV-positive and -negative women (67.3 vs. 74.4%, P = 0.73). Conclusion In women with biopsy-negative LSILs, the risk of CIN3+ diagnosed within 2 years was low; furthermore, approximately 70% underwent cytologic regression within 12 months, regardless of HPV testing results. Biopsy-negativeLSILsmay represent regressing lesions rather than lesions missed by colposcopy.

Original languageEnglish
Pages (from-to)233-239
Number of pages7
JournalInternational Journal of Clinical Oncology
Volume17
Issue number3
DOIs
Publication statusPublished - 01-06-2012

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Colposcopy
Uterine Cervical Neoplasms
Cohort Studies
Prospective Studies
Biopsy
Squamous Intraepithelial Lesions of the Cervix
Cervical Intraepithelial Neoplasia
Cell Biology

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hematology
  • Oncology

Cite this

Matsumoto, Koji ; Hirai, Yasuo ; Furuta, Reiko ; Takatsuka, Naoyoshi ; Oki, Akinori ; Yasugi, Toshiharu ; Maeda, Hiroo ; Mitsuhashi, Akira ; Fujii, Takuma ; Kawana, Kei ; Iwasaka, Tsuyoshi ; Yaegashi, Nobuo ; Watanabe, Yoh ; Nagai, Yutaka ; Kitagawa, Tomoyuki ; Yoshikawa, Hiroyuki. / Subsequent risks for cervical precancer and cancer in women with low-grade squamous intraepithelial lesions unconfirmed by colposcopy-directed biopsy : Results from a multicenter, prospective, cohort study. In: International Journal of Clinical Oncology. 2012 ; Vol. 17, No. 3. pp. 233-239.
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title = "Subsequent risks for cervical precancer and cancer in women with low-grade squamous intraepithelial lesions unconfirmed by colposcopy-directed biopsy: Results from a multicenter, prospective, cohort study",
abstract = "Objective To investigate the natural course of low-grade squamous intraepithelial lesions (LSILs) that cannot be histologically confirmed by colposcopy-directed biopsy. Methods In a multicenter, prospective, cohort study of Japanese women with LSILs, we analyzed the follow-up data from 64 women who had a negative biopsy result at the initial colposcopy (biopsy-negative LSIL) in comparison with those from 479 women who had a histologic diagnosis of cervical intraepithelial neoplasia grade 1 (LSIL/CIN1). Patients were monitored by cytology and colposcopy every 4 months for a mean follow-up period of 39.0 months, with cytologic regression defined as two consecutive negative smears and normal colposcopy. Results In women with biopsy-negative LSILs, there were no cases of CIN3 or worse (CIN3+) diagnosed within 2 years; the difference in the 2-year risk of CIN3+ between the two groups was marginally significant (0 vs. 5.5{\%}; P = 0.07). The cumulative probability of cytologic regression within 12 months was much higher in the biopsynegative LSIL group (71.2 vs. 48.6{\%}; P = 0.0001). The percentage of women positive for high-risk human papillomaviruses (hrHPVs) was significantly lower in the biopsynegative LSIL group than in the LSIL/CIN1 group (62.1 vs. 78.4{\%}; P = 0.01); however, the 12-month regression rate of biopsy-negative LSIL was similar between hrHPV-positive and -negative women (67.3 vs. 74.4{\%}, P = 0.73). Conclusion In women with biopsy-negative LSILs, the risk of CIN3+ diagnosed within 2 years was low; furthermore, approximately 70{\%} underwent cytologic regression within 12 months, regardless of HPV testing results. Biopsy-negativeLSILsmay represent regressing lesions rather than lesions missed by colposcopy.",
author = "Koji Matsumoto and Yasuo Hirai and Reiko Furuta and Naoyoshi Takatsuka and Akinori Oki and Toshiharu Yasugi and Hiroo Maeda and Akira Mitsuhashi and Takuma Fujii and Kei Kawana and Tsuyoshi Iwasaka and Nobuo Yaegashi and Yoh Watanabe and Yutaka Nagai and Tomoyuki Kitagawa and Hiroyuki Yoshikawa",
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Matsumoto, K, Hirai, Y, Furuta, R, Takatsuka, N, Oki, A, Yasugi, T, Maeda, H, Mitsuhashi, A, Fujii, T, Kawana, K, Iwasaka, T, Yaegashi, N, Watanabe, Y, Nagai, Y, Kitagawa, T & Yoshikawa, H 2012, 'Subsequent risks for cervical precancer and cancer in women with low-grade squamous intraepithelial lesions unconfirmed by colposcopy-directed biopsy: Results from a multicenter, prospective, cohort study', International Journal of Clinical Oncology, vol. 17, no. 3, pp. 233-239. https://doi.org/10.1007/s10147-011-0280-9

Subsequent risks for cervical precancer and cancer in women with low-grade squamous intraepithelial lesions unconfirmed by colposcopy-directed biopsy : Results from a multicenter, prospective, cohort study. / Matsumoto, Koji; Hirai, Yasuo; Furuta, Reiko; Takatsuka, Naoyoshi; Oki, Akinori; Yasugi, Toshiharu; Maeda, Hiroo; Mitsuhashi, Akira; Fujii, Takuma; Kawana, Kei; Iwasaka, Tsuyoshi; Yaegashi, Nobuo; Watanabe, Yoh; Nagai, Yutaka; Kitagawa, Tomoyuki; Yoshikawa, Hiroyuki.

In: International Journal of Clinical Oncology, Vol. 17, No. 3, 01.06.2012, p. 233-239.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Subsequent risks for cervical precancer and cancer in women with low-grade squamous intraepithelial lesions unconfirmed by colposcopy-directed biopsy

T2 - Results from a multicenter, prospective, cohort study

AU - Matsumoto, Koji

AU - Hirai, Yasuo

AU - Furuta, Reiko

AU - Takatsuka, Naoyoshi

AU - Oki, Akinori

AU - Yasugi, Toshiharu

AU - Maeda, Hiroo

AU - Mitsuhashi, Akira

AU - Fujii, Takuma

AU - Kawana, Kei

AU - Iwasaka, Tsuyoshi

AU - Yaegashi, Nobuo

AU - Watanabe, Yoh

AU - Nagai, Yutaka

AU - Kitagawa, Tomoyuki

AU - Yoshikawa, Hiroyuki

PY - 2012/6/1

Y1 - 2012/6/1

N2 - Objective To investigate the natural course of low-grade squamous intraepithelial lesions (LSILs) that cannot be histologically confirmed by colposcopy-directed biopsy. Methods In a multicenter, prospective, cohort study of Japanese women with LSILs, we analyzed the follow-up data from 64 women who had a negative biopsy result at the initial colposcopy (biopsy-negative LSIL) in comparison with those from 479 women who had a histologic diagnosis of cervical intraepithelial neoplasia grade 1 (LSIL/CIN1). Patients were monitored by cytology and colposcopy every 4 months for a mean follow-up period of 39.0 months, with cytologic regression defined as two consecutive negative smears and normal colposcopy. Results In women with biopsy-negative LSILs, there were no cases of CIN3 or worse (CIN3+) diagnosed within 2 years; the difference in the 2-year risk of CIN3+ between the two groups was marginally significant (0 vs. 5.5%; P = 0.07). The cumulative probability of cytologic regression within 12 months was much higher in the biopsynegative LSIL group (71.2 vs. 48.6%; P = 0.0001). The percentage of women positive for high-risk human papillomaviruses (hrHPVs) was significantly lower in the biopsynegative LSIL group than in the LSIL/CIN1 group (62.1 vs. 78.4%; P = 0.01); however, the 12-month regression rate of biopsy-negative LSIL was similar between hrHPV-positive and -negative women (67.3 vs. 74.4%, P = 0.73). Conclusion In women with biopsy-negative LSILs, the risk of CIN3+ diagnosed within 2 years was low; furthermore, approximately 70% underwent cytologic regression within 12 months, regardless of HPV testing results. Biopsy-negativeLSILsmay represent regressing lesions rather than lesions missed by colposcopy.

AB - Objective To investigate the natural course of low-grade squamous intraepithelial lesions (LSILs) that cannot be histologically confirmed by colposcopy-directed biopsy. Methods In a multicenter, prospective, cohort study of Japanese women with LSILs, we analyzed the follow-up data from 64 women who had a negative biopsy result at the initial colposcopy (biopsy-negative LSIL) in comparison with those from 479 women who had a histologic diagnosis of cervical intraepithelial neoplasia grade 1 (LSIL/CIN1). Patients were monitored by cytology and colposcopy every 4 months for a mean follow-up period of 39.0 months, with cytologic regression defined as two consecutive negative smears and normal colposcopy. Results In women with biopsy-negative LSILs, there were no cases of CIN3 or worse (CIN3+) diagnosed within 2 years; the difference in the 2-year risk of CIN3+ between the two groups was marginally significant (0 vs. 5.5%; P = 0.07). The cumulative probability of cytologic regression within 12 months was much higher in the biopsynegative LSIL group (71.2 vs. 48.6%; P = 0.0001). The percentage of women positive for high-risk human papillomaviruses (hrHPVs) was significantly lower in the biopsynegative LSIL group than in the LSIL/CIN1 group (62.1 vs. 78.4%; P = 0.01); however, the 12-month regression rate of biopsy-negative LSIL was similar between hrHPV-positive and -negative women (67.3 vs. 74.4%, P = 0.73). Conclusion In women with biopsy-negative LSILs, the risk of CIN3+ diagnosed within 2 years was low; furthermore, approximately 70% underwent cytologic regression within 12 months, regardless of HPV testing results. Biopsy-negativeLSILsmay represent regressing lesions rather than lesions missed by colposcopy.

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