Incidence of Recurrent High Grade Cervical Intraepithelial Neoplasia after Treatment of Preinvasive Cervical Lesion: A-3 Year Follow-up at Thammasat University Hospital
Promchit K, MD1, Punyashthira A, MD1, Kanjanawilai N2, Pattaraarchachai J, PhD3, Bhamarapravatana K, PhD4, Suwannarurk K, MD1
Affiliation : 1 Department of Obstetrics and Gynecology, Thammasat University Hospital, Pathumthani, Thailand 2 Medical Student, Faculty of Medicine, Thammasat University, Pathumthani, Thailand 3 Chulabhorn International College of Medicine, Thammasat University, Pathumthani, Thailand 4 Department of Preclinical Science, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Background : Cervical cancer is the third most malignancy among Thai women. Cervical intraepithelial neoplasia(CIN) 2/3 is
precancerous of cervical cancer that could be conservatively treated. A precise recurrent investigation tool is an important method.
Objective : The aim of this retrospective study is to investigate the regression and recurrence rate of CIN2/3 after three years of
treatment.
Materials and Methods : Ninety cases of CIN2/3 from participants who underwent cervical cancer screening and treated between
July 2013 and June 2016 at Gynecologic Clinic, Thammasat University Hospital, Pathumthani, Thailand and affiliated clinics were
recruited. Demographic data, method of treatment and co-testing report of participants were recorded for three consecutive years.
Results : A total of 2,144 women during the period were recruited. After those excluded, 1,505 cases were enrolled in this study. Cases
who had abnormal cervical cytology had less mean age, more sexual partners and sexual transmitted diseases than those who had
normal cervical cytology. Ninety-nine percent of the negative testing group had negative co-testing at the end of the three-year
period. Ninety cases were diagnosed with CIN2/3. The regression rates of CIN2/3 at two and three years follow-up after treatment
were 97.8% (88/90) and 95.6% (86/90), respectively. An additional four cases that had negative co-testing at first and second year
were diagnosed of CIN2/3 at third year of follow-up period.
Conclusion : The regression and recurrence rates of CIN2/3 at three-year follow-ups are 95.6 and 4.4 percent, respectively. Over-
extending by three consecutives co-testing follow-ups of CIN2/3 after treatment should be of concern.
Keywords : CIN, Pap smear, High grade, Follow-up, Excision procedure, Ablation
