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CIN cells may regress when left untreated, study finds

01 March 2018 08:43

3D render of a medical background with virus cells

3D render of a medical background with virus cells

Monitoring abnormal cervical cells could be a better option than beginning immediate cancer treatment in some cases, a new study suggests.

Traditional smear tests detect abnormal cells called cervical intraepithelial neoplasia (CIN), which, if identified early on, can be treated.

But some studies now suggest that the CIN2 cells - the most severe type - often return to normal without treatment.

3,160 women studied

The results prompted a team of researchers to estimate rates of regression, persistence and progression of untreated CIN2 lesions, as well as levels of compliance with active surveillance.

They analysed results from 36 studies involving 3,160 women with a laboratory confirmed diagnosis of CIN2 who were actively monitored for at least three months.

Differences in study design and quality were analysed as well as rates of regression, persistence, and progression were measured at three, six, 12, 24, 36 and 60 months.

The findings, published in the British Medical Journal, show that after two years 50% of the lesions had regressed spontaneously, 32% persisted, and 18% progressed to CIN3 or worse.

In women aged under 30, the rate of regression was even higher at 60%, persistence was 23%, and progression was 11%.

15 cases of cancer

Only 15 cases of cancer were reported, predominantly in women over 30 years old. Compliance with surveillance was also at around 90% over two years.

The team of researchers said: "Most CIN2 lesions, particularly in women aged less than 30, regress spontaneously.

"Active surveillance, rather than immediate intervention, is therefore justified, especially among young women who are likely to adhere to monitoring."

Treatment can be harmful for future pregnancies in younger women. The aim of this new research is that to help women make more informed choices with their doctor about the treatment of CIN cells.

According to Robert Music, chief executive of Jo's Cervical Cancer Trust, however, the findings of the study should be approached with caution.

"Some women can experience psychological or physical side effects following treatment for abnormal cells so if further evidence indicates monitoring over treatment is sufficient in some cases then this is positive," he said.

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