Topographical Distribution Pattern of Cervical Intraepithelial Neoplasia Across the Cervix

OBJECTIVE: The distribution of cervical intraepithelial neoplasia (CIN) lesions across the cervix was determined. METHODS: A total of 575 women whose pathological diagnosis after cervical conization was confirmed as CIN were studied; 146 had low-grade CIN and 429 had high-grade CIN. CIN lesion location on the cervix was recorded using 12-h clock face notation. RESULTS: In both groups, 12 o'clock was the most common and 2 o'clock the least common lesion location. The most severe lesions were most often located at 8 o'clock and 7 o'clock, in the low- and high-grade groups, respectively. The 2 o'clock site was the least frequent site for the most severe lesion in both groups. Lesions were found more frequently on the posterior lip of the cervix than on the anterior lip, and on the right side of the cervix than on the left side, in both groups. CONCLUSIONS: The distribution of CIN lesions is not randomly distributed across the cervix. The 12, 8 and 7 o'clock sites, and the posterior lip and right side of the cervix, should be targeted during colposcopy-directed biopsy of patients with CIN lesions as this may improve diagnostic accuracy.