Therapeutic Abstention and Surveillance of Intra-epithelial Histological Lesions of High Grade Cervical CIN2 (Cervical Intraepithelial Neoplasia Grade 2). SUIVICIN
Therapeutic Abstention and Surveillance of Intra-epithelial Histological Lesions of High Grade Cervical CIN2 (Cervical Intraepithelial Neoplasia Grade 2). SUIVICIN
This study proposes to describe and evaluate the rate of spontaneous regression of CIN2 at 2
 year of follow up in women between 18 and 39 year old. This follow-up is proposed as an
 alternative to the treatment of reference (conization) with a possible extension to 4 years
The INCa recommendations of December 2016 propose the destruction or abstention-monitoring of
 high-grade histological cervical lesions (HSIL) as an alternative to conization under certain
 conditions. These are women under 30 years old, with a small lesion in colposcopy, without
 any sign of invasion, with a squamocolumnar junction seen. These women must accept the
 principle of regular monitoring by cytology and colposcopy +/- biopsy every 6 months for a
 maximum of 2 years. HSIL group 2 histological entities CIN2 and CIN3. It is recognized that
 CIN2 are associated with CIN1 and CIN3 biology whose diagnosis is the result of the
 subjectivity of colposcopy allowing cervical biopsy and the variability of pathological
 interpretation due to poor reproducibility of histological diagnosis. CIN2 regress
 spontaneously in more than 50% of cases at 1 year, either completely (no lesion) or partially
 (LSIL low grade lesions). No invasive lesions are diagnosed over 2-year observation periods.
 Among the clinical, pathological and virological criteria, only the initial HPV genotyping
 seems to have a prognostic influence. There is therefore no strong scientific argument for
 routine conization in a woman over 30 years of age with a CIN2 lesion extended over more than
 two quadrants. In addition, conization is associated with an obstetrical risk (prematurity)
 and post-therapeutic colposcopic cervical stenosis complicates subsequent monitoring in case
 of abnormal smears. These considerations encourage the extension of the indications of
 abstention monitoring in the management of women with CIN2 wishing to procreate with an
 extension of the age to 39 year old, with no limit of size of the lesion and to satisfactory
 colposcopy
Inclusion Criteria:

 -  CIN2 confirmed by biopsy, age between 18 and 39 years,

 -  satisfactory colposcopy identifying the junction and the lesion,

 -  affiliated person or beneficiary of a social security scheme,

 -  having given their oral agreement and authorization to the processing of their data.

 Exclusion Criteria:

 -  Pregnancy in progress,

 -  history of conization,

 -  atypical or atypical glandular cells or cancer incidentally discovered during smear,

 -  prophylactic vaccination against HPV,

 -  active systemic infection requiring treatment, history of HIV infection, congenital or
 acquired immunodepression,

 -  long-term treatment with corticosteroids or immunosuppressants, placement under
 safeguard of justice,

 -  non-compliance with protocol requirements, in particular a supposed lack of compliance
 with long-term follow-up