Number of partners, HPV status may predict CIN regression. (Study of 93 Patients).

SAN FRANCISCO -- High-grade dysplasia regressed naturally in 52% of 93 patients, and spontaneous regression was more likely to occur if the patient tested negative for human papil-lomavirus or had fewer than five sexual partners in her lifetime, Dr. John K. Chan reported.

Given the high rate of such regression seen in these women in a randomized, double-blind study it may be reasonable to simply follow those with cervical intraepithelial neoplasia (CIN) 2 or 3 who have no evidence of human papilloma virus (HPV) and few sexual partners. Larger trials will be needed to test the safety of this hypothesis, he said during the annual meeting of the American College of Obstetricians and Gynecologists.

The study provides scarce data on the natural history of CIN 2 and 3, which usually get treated promptly by ablation, loop electrical excisional procedure, or cone biopsy. Not all CIN lesions progress, however, so the ability to predict which ones will regress could help avoid unnecessary treatment and prevent related complications such as cervical stenosis, cervical incompetence, infection, and bleeding.

All study participants had biopsy-proven and persistent CIN 2 or 3 confirmed on colposcopy 1 month after diagnosis and were randomized to 6 months of treatment with either oral beta carotene or placebo and then followed for 18 months. Regression rates were similar between treatment groups, so the investigators conducted a secondary analysis of factors that might predict spontaneous regression.

Spontaneous regression occurred in 58% of 38 CIN 2 cases and 47% of 55 CIN 3 cases. Regression was defined as CIN 2 reverting to normal or GIN 3 ...