Immediate Treatment vs Colposcopic Follow-up for Biopsy-Proven CIN 1

Exclusion Criteria

• •any one of the following will be an excluding characteristic:
• •* index Pap smear showing CIN 2, CIN 3 or cancer;
• •* index Pap smear shows atypical glandular cells of unknown significance, glandular dysplasia, or malignancy requiring immediate investigation;
• •* patients with previously identified CIN 1 by biopsy who are already in a colposcopic surveillance program;
• •* unsatisfactory colposcopic exam defined as inability to see the extent of the lesion in the endocervical canal or absence of a lesion on the ectocervix but endocervical curettage shows CIN 1;
• •* pregnancy;
• •* prior therapy for dysplasia including medical (5FU), surgical (Laser, LEEP) or cryotherapy;
• •* prior gynecologic cancer;
• •* prior pelvic radiation therapy;
• •* inability to attend outpatient follow-up visits because of geographic inaccessibility;
• •* other malignancies except non-melanoma skin cancer;
• •* immunosuppression due to diseases such as AIDS, organ transplantation, or on immunosuppressive medications such as prednisone, imuran or chemotherapy for diseases like systemic lupus;
• •* cognitively impaired or otherwise unable to obtain written informed consent;
• •* extension of the CIN 1 lesion to vagina or a separate vaginal lesion showing dysplasia;
• •* colposcopically visible condyloma outside of the transformation zone;
• •* known allergy to local analgesics;
• •* clinically evident vaginitis must be treated and resolved prior to entry on the trial;
• •* inability to read and respond in English/French;
• •* failure to provide informed consent.