Comparative outcomes of excision and active surveillance for cervical intraepithelial neoplasia 2 in women under 35: a single institutional retrospective study

Abstract

Objective This study aimed to compare the outcomes of excision (conization) and active surveillance in women under 35 years of age diagnosed with cervical intraepithelial neoplasia 2 (CIN 2) on disease regression to normal cervical cytology and the effectiveness of nonsurgical management. Methods This retrospective cohort study was conducted at CHA University Ilsan Medical Center. Women under 35 diagnosed with CIN 2 were included and divided into two groups based on the management strategy: excisional treatment or active surveillance. Data on patient outcomes, including the regression time to normal cytology, were retrospectively collected and analyzed. Results The follow-up period ranged from 2.73 months to 42.6 months, with a median follow-up period of 6.8 months. Management strategies between the excisional procedure and active surveillance were not associated with the cytological normalization from CIN 2 (P=0.32). The median time to achieve normal cytology was 7.4 months (95% confidence interval [CI], 6.08-8.77) in the excision group and 12.8 months (95% CI, 10.34-15.22) in the active surveillance group (P=0.22). This trend was observed across the following age groups: 20-24, 25-29, and 30-34 years (20-24, P=0.96; 25-29, P=0.67; and 30-34, P=0.99). Conclusion There was no significant difference between the excisional procedure and active surveillance in terms of achieving normalized cytology from CIN 2. Active surveillance is a feasible option for managing CIN 2 in women under 35 years of age.