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Prevalence of High-grade Cervical Lesion (CIN 2+) in Thai Women with High Grade Squamous Intraepithelial Lesion Cytology

Nuttavut Kantathavorn1,2, Victoria Yuan3, Asama Vanichtantikul2, Wasanai Krisorakun2, Thanita Wetcho2, Pornprom Ittiamornlert2, Thaniya Sricharunrat4, Narongchai Teerayathanakul4, Taksa Luasiripanthu4, Siriporn Saeloo5, Waraphorn Krongthong5

Affiliation : 1 Faculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand, 2 Gynecologic Oncology Division, Woman Health Center, Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand, 3 Renaissance School of Medicine at Stony Brook University, New York, USA, 4 Pathology Division, Chulabhorn Hospital, HRH Princess Chulabhorn College of MedicalScience, Chulabhorn Royal Academy, Bangkok, Thailand, 5 Data Management Unit, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand

Background: The prevalence of high-grade cervical intraepithelial neoplasia (CIN2+), especially invasive cancer, among Thai women with high-grade squamous intraepithelial lesion (HSIL) cytology was reported higher than in Western populations. The aim of this study was to evaluate the prevalence of underlying significant cervical lesions (CIN2+) in women with HSIL cytology.
Materials and Methods: A total of 4,487 women from the Woman Health Centre of Chulabhorn Hospital, Bangkok and 1,523 women from Bangkhayaeng District of Pathumthani province, Thailand, who participated in a cervical cancer screening program between July 2011 and August 2013, were recruited into the study. A total of 22 women (14 from Chulabhorn Hospital and 8 from Bangkhayaeng District) with HSIL cytology were recruited for colposcopic evaluations.
Results: Of the 22 women with HSIL cytology, the median age was 42 years (22 to 67 years). The majority of patients were multiparous (90.9%) and premenopausal (72.7%). Final pathological results were as follows: 20 (91.0%) with CIN 2, CIN3 or adenocarcinoma in situ; 0 (0%) with CIN 1; 1 (4.5%) with no epithelial lesion; and 1 (4.5%) with cervical cancer. No clinical factors were associated with CIN2+.
Conclusion: Rates of CIN 2+ at initial colposcopy following HSIL cytology in our population were very high (95.5%) and support the “see-and-treat” strategy for HSIL cytology management.

doi.org/10.35755/jmedassocthai.2021.S02.12569

Keywords : Prevalence, Cervical intraepithelial neoplasia (CIN), High-grade squamous intraepithelial lesion (HSIL), See and treat,

Thailand


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