The natural history of XXXX of the uterine cervix. Long-term observational and histological data.

@entity1 @entity281 @entity8046
BACKGROUND: To investigate the natural history of @entity281 of the uterine cervix following a 10-year prospective observational study. @entity1 AND METHODS: Three hundred and thirty @entity1 with cytological and colposcopic features of @entity281 +/- @entity8046 1 were recruited into the study. These @entity1 were followed up for a period of 10 years, during which time they had repeated colposcopic assessments and cytological monitoring Those @entity1 with evidence of high-grade disease at any stage of follow-up were treated by Large Loop excision of the transformation zone (LLETZ) and excluded from the study. At the end of the surveillance period, 179 @entity1 with evidence of persistent @entity281 alone or in conjunction with low-grade disease underwent a shallow diagnostic LLETZ. In total, 51 @entity1 defaulted from follow-up. RESULTS: Thirty-three per cent of the @entity1 with cytological and colposcopic features suggestive of persistent @entity281 alone during the 10-year follow-up period had histological evidence of @entity8046 at the end of the study. Two thirds of this disease was graded as @entity8046 2 or 3. Nineteen per cent of the @entity1 with cytological and colposcopic features suggestive of persistent @entity281 and @entity8046 1 actually had high-grade @entity8046 at histology ( @entity8046 2 and 3). Only 6.1% of the study population had normal histological findings. CONCLUSION: The finding that a relatively large percentage of high-grade lesions might have been masked for anything up to a decade by a low-grade phenotype, coupled with the worrying percentage of defaulters from follow-up, indicate that an early decision for intervention (diagnostic and/or therapeutic) may be appropriate if a low-grade abnormality persists after a short surveillance period.
