Follow up in women with biopsy diagnosis of cervical low-grade squamous intraepithelial lesion (LSIL): how long should it be?

Abstract

To analyse the regression rate and the risk of persistence or progression of the lesions in women with a histopathological diagnosis of cervical low-grade squamous intraepithelial lesion (LSIL). Retrospective cohort study of women with biopsy diagnosis of cervical LSIL, from January 2010 to December 2013. After the initial diagnosis of LSIL, all the women underwent scheduled follow-up examinations with cytology every 6months for 2years and an HPV test after 1year. At the 24-month follow-up, the regression of cervical LSIL was observed in 88.5% of the women. 10.8% of the women had a persistent lesion, while a progression towards cervical HSIL was reported in 0.7% of the women. The risk of persistence or progression of histological LSIL was higher in women with ASC-H or HSIL on the referral cytology and in tobacco users. In women with biopsy diagnosis of cervical LSIL, preceded by ASCUS or LSIL on cytology, a high rate of regression was observed and, in most of the cases, the regression occurred in the first year of follow-up. In women with cervical LSIL, preceded by ASC-H or HSIL on cytology, and in tobacco users, a higher risk of persistence and progression was observed. Thus, in these cases, repeated follow-up examinations, even with the HR-HPV test, are advisable.