patient with a cin 1 cytology report should be scheduled for follow up when

by Amya Kovacek 8 min read

ACOG Releases Guidelines for Management of Abnormal …

30 hours ago Follow-up of untreated CIN 1 should include two cytology screening tests six months apart, with colposcopy for an ASC or higher-grade result, or a single … >> Go To The Portal


Patients with CIN 1 or less were re-examined with cytology at 4-6-month intervals for up to 12 months only if the cytologic result was ASC-US or worse. Correlation between HPV infection at baseline and the follow-up results was analyzed using Chi-square statistical method and Fisher's exact test.

Follow-up of untreated CIN 1 should include two cytology screening tests six months apart, with colposcopy for an ASC or higher-grade result, or a single HPV test at 12 months, with colposcopy if the test result is positive.Feb 15, 2006

Full Answer

When should HPV testing be included in post-operative follow-up of CIN2+ patients?

HPV testing should be routinely included (with or without cytology) in post-treatment follow-up of CIN2+ patients for early detection of recurrence and cancer progression.

What is a suspicious a cytology report?

A cytology report recorded as suspicious is not considered as diagnostic of cancer and unless supported by a positive biopsy (as reported on a pathology report) or by a clinical impression of cancer, these cases should not be abstracted.

What is the risk of cin1 to CIN2 evolution?

A CIN1 is associated with a risk of evolution to a CIN2 or more severe lesion that is not markedly more important than the risk associated with a LSIL/ASC-US pap smear while the colposcopy is normal or the biopsy is negative (between 8 and 13% whatever the results of the initial colposcopy) (LE 2/3).

What is cin1 Grade 1 cervical neoplasia?

A cervical intraepithelial neoplasia grade 1 (CIN1) is a lesion of basal cells consisting in an architecture disorganization and cytological atypia limited to the lower third of the cervical epithelium. It is considered as a precancerous lesion uterine cervix carcinoma while they spontaneously regress in more than 60% of cases in two years.

What happens if I have CIN 1?

CIN 1 is not cancer and usually goes away on its own without treatment, but sometimes it can become cancer and spread into nearby tissue. CIN 1 is sometimes called low-grade or mild dysplasia. Also called cervical squamous intraepithelial neoplasia 1.

How long does it take for CIN 1 to regress?

At six months, 49 percent regressed to negative, 35 percent had persistent CIN 1, and 7 percent had high-grade lesions. Among patients with negative results at 6 months and followed to 12 months, 80 percent remained negative, 16 percent had low-grade lesions, and 4 percent had high-grade lesions.

How long does it take for CIN1 to progress?

In general, it takes 10 to 20 years for CIN to progress to cancer, allowing a significant time period for detection and treatment. Progression from CIN to cancer requires persistent HPV infection.

How long can you have CIN 1?

These changes may be called HPV alone, or other cells may be present which are called CIN-1. 80% of these LSIL abnormalities go away within 12mths.

Is LEEP necessary for CIN1?

The clinical management of women with CIN 1 lesions may take one of the following courses: (i) immediate treatment or (ii) follow the woman and then treat if the lesion is persistent or progressive after 18 to 24 months. All women with CIN 2 and CIN 3 lesions should be treated with cryotherapy or LEEP.

Should I worry about CIN1?

CIN1 is the least serious form of cell abnormality and it may well clear on its own with no intervention, just monitoring more regularly. The colposcopy is a closer examination of the cervix, which will let be able to confirm the result of the smear.

What does CIN1 stand for?

Introduction. Cervical intraepithelial neoplasia grade 1 (CIN1) is the most common histologic biopsy diagnosis following referral for colposcopy for a positive cervical cancer-screening test.

How long after infection by HPV is it detectable?

A: Changes consistent with HPV can usually be detected within 3-6 months after exposure to the infection.

How long after HPV infection to abnormal cells appear?

HPV-related cancers often take years to develop after getting an HPV infection. Cervical cancer usually develops over 10 or more years. There can be a long interval between being infected with HPV, the development of abnormal cells on the cervix and the development of cervical cancer.

Does CIN1 need treatment?

Monitoring abnormal cells With low-grade cervical dysplasia, classified as CIN 1, you likely won't need treatment. In the majority of these cases, the condition goes away on its own. Only about 1% of cases progress to cervical cancer.

Can CIN1 cause bleeding?

Most people with a cervix will not experience symptoms with CIN, which is why cervical screening is so necessary. Postcoital bleeding is one sign of CIN.

What is Lsil CIN1?

— LSIL is mild or moderate dysplasia (CIN 1 and CIN 2). It almost always indicates that an HPV infection is present, but it also may indicate mild precancer changes. LSIL is very common and usually goes away on its own without treatment.

How effective is LEEP for CIN1?

Results: Of the 311 women who underwent LEEP, 283 reported for 1-year follow-up and 248 (87.6%) were disease free. Cure rates were 93.0% for CIN 1, 85.5% for CIN 2, and 72.7% for CIN 3. Minor adverse effects were observed in 34 women and complications were seen in 5 women.

How do you get rid of CIN1?

If your cervical dysplasia is more severe (CIN 1 or CIN 2), your healthcare provider can remove the abnormal cells that may become cancerous or destroy them. These procedures may include: Loop electrosurgical excision procedure (LEEP) uses a small, electrically charged wire loop to remove tissue.

What are the chances of abnormal cells returning?

After treatment for cell changes: about 9 in 10 (90%) people will not have cell changes again. fewer than 2 in 10 (between 5% and 15%) people may have cell changes that come back.

Can CIN come back after LEEP?

About 23% of patients develop CIN2+ after LEEP treatment due to residual or recurrent lesions. The majority of patients with HPV infection were HPV negative before treatment, but 16,4% were still HPV 16 positive after treatment, indicating that conization do not necessarily clear HPV infection rapidly.

Why is it difficult to diagnose a CIN1?

One of the problems encountered when facing a CIN1 is to misdiagnose a more severe lesion firstly because of the intra- and interobserver variability and secondly because the colposcopy-directed biopsy is not mandatorily representative of the more severe lesion.

What is the recommendation in case of CIN1?

The recommendation in case of CIN1 is a strict follow-up. A colposcopy and a treatment are necessary in case of persistence or progression of the abnormalities (LE2).

What is a CIN1?

A cervical intraepithelial neoplasia grade 1 (CIN1) is a lesion of basal cells consisting in an architecture disorganization and cytological atypia limited to the lower third of the cervical epithelium. It is considered as a precancerous lesion uterine cervix carcinoma while they spontaneously regress in more than 60% of cases in two years. The problems related to the management of CIN1 as defined by the recommendations established in 2002 are the over-treatment and the great variability of clinical practices. Moreover, the potential of new tests has been investigated since 2002. To establish these new recommendations, the medline database has been consulted and the references essentially published between 2001 and May 2007 have been investigated. Publications were selected and classified according to their level of evidence (LE) in order to establish the grade of recommendations. One of the problems encountered when facing a CIN1 is to misdiagnose a more severe lesion firstly because of the intra- and interobserver variability and secondly because the colposcopy-directed biopsy is not mandatorily representative of the more severe lesion. Nevertheless, because the risk of cancer is extremely low, a conization is not necessary in an asymptomatic woman with a LSIL/ASC-US pap smear in case of CIN1 even if the squamocolumnar junction is not entirely visualized (LE 2/3). The endocervical curettage cannot be recommended in this case because its efficacy is globally poor and unknown in case of CIN1. Concerning the natural history of CIN1, the recent studies, which included more than 1200 women and more than 700 for two of them, confirm that the rate of progression of a CIN1 to a CIN3 or more severe lesion is less than 9% in the two years following the initial diagnosis (LE2). A CIN1 is associated with a risk of evolution to a CIN2 or more severe lesion that is not markedly more important than the risk associated with a LSIL/ASC-US pap smear while the colposcopy is normal or the biopsy is negative (between 8 and 13% whatever the results of the initial colposcopy) (LE 2/3). The recommendation in case of CIN1 is a strict follow-up. A colposcopy and a treatment are necessary in case of persistence or progression of the abnormalities (LE2). Data from trials studying the contribution of HPV testing in case of CIN1 show that its sensitivity is similar to repeat cytology with less referral to colposcopy to detect CIN2 or more severe lesion. These data have been considered to establish follow-up recommendations to manage CIN1: if the exams (cytology and/or HPV testing) at 12 months are negative, patients can be followed by an annual cytology. In case of aggravation of the cytology, a colposcopy is necessary. In case of positive HPV testing or persisting ASC-US/LSIL at 12 months, a repeat control is necessary at 18 months and a treatment is proposed according to colposcopy findings.

Is there evidence of a malignant neoplasm?

No evidence of a malignant neoplasm, no atypical cells. Atypical cells present but no evidence of malignant neoplasm. Cells present causing suspicion of malignant neoplasm. Fairly conclusive evidence of malignant neoplasm. Conclusive evidence of malignant neoplasm. Some medical records will contain more than one cytology report.

Can a cytology report be more than one?

Conclusive evidence of malignant neoplasm. Some medical records will contain more than one cytology report. If there are multiple reports on the same type and source of specimen, record the findings on the first positive report.

Is a cytology report considered a biopsy?

Cytology Report. A cytology report recorded as suspicious is not considered as diagnostic of cancer and unless supported by a positive biopsy (as reported on a pathology report) or by a clinical impression of cancer, these cases should not be abstracted. The Papanicolaou classification of cells for the detection of malignancy ("Pap" smear) ...