CIN question

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Neoplastic

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Hey guys,

Hoping one of you could clarify a cervical pathology question for me: guidelines for managing CIN 2 are to manage conservatively (ie repeat surveillance) for adolescents and young women.

My question is, what's considered a "young woman" in standard ob/gyn practice? <18? <21? <30? Would someone in her mid-twenties typically be recommended for excision/ablation or surveillance (assuming that the patient herself is on the fence).

Thanks in advance
 
"Adolescent & Younger Women" are grouped together based on prevalence of HRHPV in this population and given the likelihood of CIN 2 regression. The group (according to the 2006 consensus statement) comprises of women aged 13-20 years.

As for your question regarding a women older than 20 years, for CIN 2, excision or ablation is preferred, but with high anxiety you can always offer close observation. Except for hysterectomy, you can defend any management option.

Hope this helps!
 
And what is considered close observation? In other words, what is the usual modality (colposcopy, hpv testing, pap) and what is the frequency (q3mth, q6mth, annually)?

Thanks again!
 
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