Imperial College London
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Professor Maria Kyrgiou

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Chair in Gynaecologic Oncology
 
 
 
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Contact

 

+44 (0)20 7594 2177m.kyrgiou Website

 
 
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Location

 

Institute of Reproductive and Developmental BiologyHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Tainio:2018:10.1136/bmj.k499,
author = {Tainio, K and Athanasiou, A and Tikkinen, KAO and Aaltonen, R and Cárdenas, J and Hernándes and Glazer-Livson, S and Jakobsson, M and Joronen, K and Kiviharju, M and Louvanto, K and Oksjoki, S and Tähtinen, R and Virtanen, S and Nieminen, P and Kyrgiou, M and Kalliala, I},
doi = {10.1136/bmj.k499},
journal = {BMJ},
pages = {1--11},
title = {Clinical course of untreated cervical intraepithelial neoplasia grade 2 under active surveillance: systematic review and meta-analysis},
url = {http://dx.doi.org/10.1136/bmj.k499},
volume = {360},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVE: To estimate the regression, persistence, and progression of untreated cervical intraepithelial neoplasia grade 2 (CIN2) lesions managed conservatively as well as compliance with follow-up protocols. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from 1 January 1973 to 20 August 2016. ELIGIBILITY CRITERIA: Studies reporting on outcomes of histologically confirmed CIN2 in non-pregnant women, managed conservatively for three or more months. DATA SYNTHESIS: Two reviewers extracted data and assessed risk of bias. Random effects model was used to calculate pooled proportions for each outcome, and heterogeneity was assessed using I2statistics. MAIN OUTCOME MEASURES: Rates of regression, persistence, or progression of CIN2 and default rates at different follow-up time points (3, 6, 12, 24, 36, and 60 months). RESULTS: 36 studies that included 3160 women were identified (seven randomised trials, 16 prospective cohorts, and 13 retrospective cohorts; 50% of the studies were at low risk of bias). At 24 months, the pooled rates were 50% (11 studies, 819/1470 women, 95% confidence interval 43% to 57%; I2=77%) for regression, 32% (eight studies, 334/1257 women, 23% to 42%; I2=82%) for persistence, and 18% (nine studies, 282/1445 women, 11% to 27%; I2=90%) for progression. In a subgroup analysis including 1069 women aged less than 30 years, the rates were 60% (four studies, 638/1069 women, 57% to 63%; I2=0%), 23% (two studies, 226/938 women, 20% to 26%; I2=97%), and 11% (three studies, 163/1033 women, 5% to 19%; I2=67%), respectively. The rate of non-compliance (at six to 24 months of follow-up) in prospective studies was around 10%. CONCLUSIONS: Most CIN2 lesions, particularly in young women (<30 years), regress spontaneously. Active surveillance, rather than immediate intervention, is therefore justified, especially among young women who are likely to adhere to mon
AU  - Tainio,K
AU  - Athanasiou,A
AU  - Tikkinen,KAO
AU  - Aaltonen,R
AU  - Cárdenas,J
AU  - Hernándes
AU  - Glazer-Livson,S
AU  - Jakobsson,M
AU  - Joronen,K
AU  - Kiviharju,M
AU  - Louvanto,K
AU  - Oksjoki,S
AU  - Tähtinen,R
AU  - Virtanen,S
AU  - Nieminen,P
AU  - Kyrgiou,M
AU  - Kalliala,I
DO  - 10.1136/bmj.k499
EP  - 11
PY  - 2018///
SN  - 0959-8138
SP  - 1
TI  - Clinical course of untreated cervical intraepithelial neoplasia grade 2 under active surveillance: systematic review and meta-analysis
T2  - BMJ
UR  - http://dx.doi.org/10.1136/bmj.k499
UR  - https://www.ncbi.nlm.nih.gov/pubmed/29487049
UR  - https://www.bmj.com/content/360/bmj.k499
UR  - http://hdl.handle.net/10044/1/56160
VL  - 360
ER  -
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