Recurrence of cervical intraepithelial neoplasia stratified by age.

Abstract

Background: Cervical cancer is one of the leading causes of death among women in countries with middle to high income levels.

Objective: Stratifying the predictors of recurrence/persistence of grade 2 or 3 CIN after primary conization in different age groups, is the object of analysis of our study.

Material and methods: A total of 432 women with cervical intraepithelial neoplasia (CIN) attended from January 2017 to May 2020 were included. Information regarding age at diagnosis, immunosuppression and cytologic, colposcopy, LEEP or cervical cone biopsy and histopathological results were acquired. Recurrence incidence was calculated over follow-up time in months. To evaluate the association between patient's characteristics and recurrence, we calculated hazard ratio (HR) with 95% CI.

Results: We observed 25 recurrences from 432 women and 4,869 months of follow-up (5.13 incidence per 1,000 months). Median age was 38 years old. Median follow-up was 6.8 months. The recurrence-free period at 1, 2 and 3 years was 95.47%, 82.18% and 44.09% respectively. In the bivariate analysis, factors associated with the risk of recurrence were the following: high grade cytological diagnosis (HR = 3.04, IC 95% = 1.18-7.31), colposcopy grade 2 or cancer suspected (HR = 3.04, IC 95% = 1.25-7.22), high grade biopsy diagnosis (HR = 3.07, IC95 % = 1.28-7.30), LEEP or hysterectomy (HR = 2.85, IC95 % = 1.19-6.78).

Conclusions: High-grade lesions, colposcopy findings and pathological diagnosis were also associated with disease recurrence.