Management choice and adherence to follow-up after colposcopy in women with cervical intraepithelial neoplasia 1

Obstet Gynecol. 2001 Oct;98(4):674-9. doi: 10.1016/s0029-7844(01)01526-5.


Objective: To determine women's preference when given a choice of management between cryotherapy and cytology surveillance and to compare subsequent adherence to serial cytologic follow-up after being diagnosed with cervical intraepithelial neoplasia grade 1 (CIN1).

Methods: Two hundred nineteen low-income women with biopsy-proven CIN1 seen in a reproductive health clinic from August 1995 through December 1999 were offered cryotherapy or cytology surveillance, followed by cytologic testing every 4 months until three consecutive results were normal. Endpoints of the study were: successful completion of follow-up; transferred or referred out of clinic; or lost to follow-up.

Results: Ninety-four women (42.9%) chose cryotherapy, compared with 125 women (57.1%) who chose cytology surveillance (P < .05). Cryotherapy patients were more likely to return for at least one visit (their treatment visit) after colposcopy compared with cytology surveillance patients (P < .001). In contrast to their initial return for treatment of 98.9%, cryotherapy patients were less likely to return for their first follow-up cytology visit compared to surveillance-only patients (68.1% and 83.2%, respectively, P < .01). Thirty-seven percent of the total group successfully completed follow-up at the clinic, 30.1% transferred or were referred, and 32.9% were lost to follow-up.

Conclusion: Successful completion of a commonly recommended protocol for serial cytology follow-up was low. Management choice affected initial adherence but not adherence to long-term follow-up.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Cervical Intraepithelial Neoplasia / diagnosis
  • Cervical Intraepithelial Neoplasia / pathology
  • Cervical Intraepithelial Neoplasia / therapy*
  • Colposcopy
  • Cryotherapy*
  • Female
  • Humans
  • Middle Aged
  • Patient Acceptance of Health Care*
  • Prospective Studies
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / therapy*
  • Vaginal Smears*