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

Abstract 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%.