{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:24:04Z","timestamp":1773923044863,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2010,11,8]],"date-time":"2010-11-08T00:00:00Z","timestamp":1289174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2011,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>The optimal management strategy for women with low\u2010grade biopsy\u2010proven cervical intraepithelial neoplasia (CIN) is not clear. Our objective was to compare the effectiveness of regular colposcopic follow\u2010up and treatment of progressive disease only versus immediate treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>Data were accrued between November 2000 and March 2006 for a noninferiority randomized clinical trial of 415 women with biopsy\u2010proven grade 1 CIN from 8 Canadian and 2 Brazilian colposcopy clinics. Subjects were randomly assigned to either undergo immediate treatment with a loop electrical excision procedure (LEEP) or receive regular colposcopic follow\u2010up for 18 months. The primary outcome was progression of disease to CIN 2 to 3 was based on histology obtained during 18 months of follow\u2010up. Treatments were compared using differences of proportion with a 9% noninferiority margin. Analysis was conducted on the basis of intention\u2010to\u2010treat.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>An initial LEEP was performed on 179 women. Disease progression was found in 32. Easily controlled vaginal bleeding occurred in 16 (8.9%). During follow\u2010up, disease progression was identified in 3 (1.7%) women in the immediate treatment arm and 9 (4.4%) in the colposcopic follow\u2010up arm\u2014a tolerable difference of 2.7% with 1\u2010sided 95% confidence interval (CI) upper limit of 6.0%. Compliance with all 3 follow\u2010up visits was 61% overall, but significantly worse in women \u226430 years of age (<jats:italic>P<\/jats:italic> &lt; .05).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>The risk of progression to CIN grade 2 or 3 or cancer over 18 months was similar in the 2 treatment groups. In Canada and Brazil, follow\u2010up for 18 months is a reasonable management strategy for women with persistent low\u2010grade cytology who are found to have grade 1 CIN on referral for colposcopy and cervical biopsy. Cancer 2011. \u00a9 2010 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.25635","type":"journal-article","created":{"date-parts":[[2010,11,8]],"date-time":"2010-11-08T16:47:30Z","timestamp":1289234850000},"page":"1438-1445","source":"Crossref","is-referenced-by-count":27,"title":["Expectant management versus immediate treatment for low\u2010grade cervical intraepithelial neoplasia"],"prefix":"10.1002","volume":"117","author":[{"given":"Laurie","family":"Elit","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark N.","family":"Levine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jim A.","family":"Julian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W.","family":"Sellors","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Lytwyn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvia","family":"Chong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James B.","family":"Mahony","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ChuShu","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terri","family":"Finch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz C.","family":"Zeferino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,11,8]]},"reference":[{"key":"e_1_2_7_2_2","first-page":"O0087","article-title":"Leung, Leung M, Osborne R","author":"Osborne R","year":"1998","journal-title":"Soc Obstet Gynecol Can."},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(98)00245-2"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004347-199304000-00018"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/91.3.252"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-0528.2003.00007.x"},{"issue":"2","key":"e_1_2_7_7_2","article-title":"Surgery for cervical intraepithelial neoplasia","author":"Martin\u2010Hirsch PL","year":"2000","journal-title":"Cochrane Database Syst Rev."},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68181-6"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/pgp.0b013e31814fb1da"},{"key":"e_1_2_7_10_2","first-page":"88","article-title":"Colposcopist agreement study on worst site to biopsy on the cervix","volume":"34","author":"Elit L","year":"2007","journal-title":"Clin Exp Obstet Gynecol."},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.1995.tb01868.x"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780091208"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)32051-5"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.456"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67069-9"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-0976.1999.08115.x"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(01)01526-5"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2006.04.001"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2548"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e318159408b"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.25635","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.25635","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T20:06:33Z","timestamp":1760299593000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.25635"}},"subtitle":["A randomized trial in Canada and Brazil"],"short-title":[],"issued":{"date-parts":[[2010,11,8]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2011,4]]}},"alternative-id":["10.1002\/cncr.25635"],"URL":"https:\/\/doi.org\/10.1002\/cncr.25635","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,11,8]]}}}