{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T05:50:25Z","timestamp":1782971425562,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008363","name":"Kr\u00e6ftens Bek\u00e6mpelse","doi-asserted-by":"publisher","award":["R327\u2010A18940"],"award-info":[{"award-number":["R327\u2010A18940"]}],"id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Active surveillance for cervical intraepithelial neoplasia grade 2 (CIN2) has been implemented recently in many countries, including the Nordic countries. In Denmark, the only eligibility criterion for active surveillance for CIN2 is that the woman should be of reproductive age. With this study, we aimed to evaluate clinical and socioeconomic characteristics in women with CIN2 managed by active surveillance or large loop excision of the transformation zone (LLETZ) and to evaluate temporal changes in the clinical management of CIN2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>We conducted a Danish nationwide study using data from healthcare registries. All female residents aged 18\u201340\u2009years, diagnosed with incident CIN2 from January 1, 1998, to February 29, 2020, were included. We collected data on age, index cytology result, year of CIN2 diagnosis, region of residence, civil status, HPV vaccination status, and socioeconomic position indicators. The variables were tabulated overall and by management group (active surveillance vs. LLETZ). To evaluate time trends, we used joinpoint regression to calculate the annual percentage change (APC), including 95% confidence intervals (CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 27\u2009536 women with CIN2 included, 12\u2009500 (45.4%) underwent active surveillance, and 15\u2009036 (54.6%) underwent a LLETZ. Women undergoing active surveillance were younger, more often HPV\u2010vaccinated, and more likely to have a normal\/low\u2010grade index cytology result than women undergoing LLETZ. Socioeconomic position indicators did not differ. Over time, the proportion of women undergoing active surveillance increased from 21.7% in 2004 to 73.6% in 2019 (APC 9.7, 95% CI 8.1\u201311.4). The proportion of women undergoing active surveillance aged &lt;30 declined over time (APC \u22122.2, 95% CI \u22122.9 to \u22121.5). The proportion of women with normal\/low\u2010grade index cytology increased slightly to 51.6% in 2019 (APC 0.8, 95% CI 0.4\u20131.3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of active surveillance for CIN2 has increased over the past two decades in Denmark. Observed differences in characteristics between women undergoing active surveillance vs LLETZ are likely related to indications for clinical management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14908","type":"journal-article","created":{"date-parts":[[2024,7,13]],"date-time":"2024-07-13T05:38:33Z","timestamp":1720849113000},"page":"1771-1780","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Time trends in the clinical management of cervical intraepithelial neoplasia grade 2: A Danish register\u2010based study"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7155-6140","authenticated-orcid":false,"given":"Dina Overgaard","family":"Eriksen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology G\u00f8dstrup Hospital  Herning Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina Hovgaard","family":"Randrup","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology G\u00f8dstrup Hospital  Herning Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1657-8600","authenticated-orcid":false,"given":"Kathrine Dyhr","family":"Lycke","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology G\u00f8dstrup Hospital  Herning Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9400-662X","authenticated-orcid":false,"given":"Rikke Kamp","family":"Damgaard","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology G\u00f8dstrup Hospital  Herning Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnny","family":"Kahlert","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Clinical Epidemiology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva Bjerre","family":"Ostenfeld","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Obstetrics and Gynecology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pernille Tine","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Obstetrics and Gynecology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Wentzensen","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics National Cancer Institute  Rockville Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan A.","family":"Clarke","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics National Cancer Institute  Rockville Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4616-9827","authenticated-orcid":false,"given":"Anne","family":"Hammer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology G\u00f8dstrup Hospital  Herning Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.08.008"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k499"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i3633"},{"key":"e_1_2_12_5_1","unstructured":"Danish Society of Obstetrics and Gynecology.Udredning behandling og kontrol af cervikal dysplasi [Investigation treatment and control of cervical dysplasia].2012. 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