Conservative management of CIN2 within primary HPV cervical cancer screening programme: a cohort study

Conservative management of CIN2 within primary HPV cervical cancer screening programme: a cohort study | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 5 May 2025 V1 Latest version Share on Conservative management of CIN2 within primary HPV cervical cancer screening programme: a cohort study Authors : Francesca Leoni 0009-0002-7182-4608 , Paolo GiorgiRossi [email protected] , Corrado Morana , Roberta Marchione , Serena Domenighini , Cristina Ruggeri , Massimo Confortini , and Luigi Pasquale Authors Info & Affiliations https://doi.org/10.22541/au.174642677.76597794/v1 Published Journal of Lower Genital Tract Disease Version of record Peer review timeline 193 views 95 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Objective To quantify the probabilities of HPV-persistence, viral clearance, or treatment at 24 months in women with CIN2 managed conservatively; describing the determinants of the decision for conservative management, losses to follow-up, and histological findings in treated women. Design Prospective single-arm intervention study. Setting HPV-based pilot screening in Vallecamonica-Sebino, Italy. Population Women with biopsy-confirmed CIN2. Methods Women with CIN2 assessed as low-risk by gynecologists were proposed for conservative management, those who refused received treatment, those who accepted were followed up with HPV, cytology, and colposcopy at 6, 12 and 24 months, then if lesion persisted, treatment was recommended. Competing-risk models were used for investigating the determinants of viral clearance and log-binomial models for the determinants of decision for conservative management and loss to follow up. Main outcome measures Clearance, treatment, or HPV-persistence at 24 months; decision for conservative management and follow-up losses. Results 180 out of 352 women with CIN2 chose conservative management. Within 24 months, 40.6% of women (95% CI 32.8-48.8%) achieved viral clearance, 43.9% (95% CI 35.9-52.1%) underwent delayed treatment, and 15.5% (95% CI 10.2-22.2%) remained HPV-positive. Younger age, immediate colposcopy referral, low-grade cytological and grade I colposcopy were associated with the conservative management decision. Women diagnosed during subsequent screening rounds were more likely to achieve viral clearance (Hazard Ratio 1.95 (95% CI 1.11–3.40)) and had better adherence to follow-up tests. Two cases of invasive carcinoma were identified in treated women. Conclusions Women diagnosed in later HPV screening rounds are more suitable candidates for safe and effective conservative management. Supplementary Material File (main_document.docx) Download 205.56 KB File (table_1.docx) Download 22.15 KB File (table_2.docx) Download 14.65 KB File (table_3.docx) Download 13.55 KB File (table_4.docx) Download 14.05 KB File (table_5.docx) Download 12.53 KB Information & Authors Information Version history V1 Version 1 05 May 2025 Peer review timeline Published Journal of Lower Genital Tract Disease Version of Record 1 Apr 2026 Published Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords cin: diagnosis cin: treatment clinical guidelines cytology: screening gynaecological oncology Authors Affiliations Francesca Leoni 0009-0002-7182-4608 Azienda Unita Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia View all articles by this author Paolo GiorgiRossi [email protected] Azienda Unita Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia View all articles by this author Corrado Morana Aziende Socio Sanitarie Territoriale della Valcamonica View all articles by this author Roberta Marchione Aziende Socio Sanitarie Territoriale della Valcamonica View all articles by this author Serena Domenighini Agenzia di Tutela della Salute della Montagna View all articles by this author Cristina Ruggeri Agenzia di Tutela della Salute della Montagna View all articles by this author Massimo Confortini Istituto per lo Studio la Prevenzione e la Rete Oncologica View all articles by this author Luigi Pasquale Ex ASL Vallecamonica-Sebino Regione Lombardia View all articles by this author Metrics & Citations Metrics Article Usage 193 views 95 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Francesca Leoni, Paolo GiorgiRossi, Corrado Morana, et al. Conservative management of CIN2 within primary HPV cervical cancer screening programme: a cohort study. Authorea . 05 May 2025. DOI: https://doi.org/10.22541/au.174642677.76597794/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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