Are there predictors for failed expectant management of cervical intraepithelial neoplasia 1?

OBJECTIVE: To identify the short-term natural history of cervical intraepithelial neoplasia (CIN) 1 and the potential risk factors for its progression, regression and persistence and to identify any characteristics of patients who were lost to follow-up. STUDY DESIGN: All colposcopic specimens from July 2001 through December 2004 were evaluated for the presence of CIN 1. Adequate follow-up was defined as 24 months of surveillance with Pap smears every 4-6 months. The chi(2) and Student t test were performed for analysis. RESULTS: Three hundred sixty women who had colposcopic specimens with the presence of CIN 1 were evaluated. Persistence of CIN 1 and progression to CIN 2 and 3 were associated with pregnancy at the time of colposcopy (p=0.04), history of sexually transmitted diseases (p = 0.007) and age at first intercourse (p = 0.04). Age (p = 0.001) and no prior history of abnormal Pap smears (p = 0.001) were associated with the rate of loss to follow-up. CONCLUSION. Expectant management for the majority of patients with biopsy-proven CIN 1 is appropriate, but some risk factors might influence that decision. In this study, age at first intercourse was the only independent predictor of failure to resolve CIN 1 on multivariate analysis.