The management of minor degrees of cervical dysplasia associated with the human papilloma virus.

This report attempts to define further the natural history of minor degrees of cervical dysplasia associated with human papilloma virus (HPV). Five hundred and twenty-five patients with a diagnosis of mild to moderate cervical dysplasia and HPV effects were followed without treatment for six months to five years. Those patients who progressed to a greater degree of dysplasia were removed from follow-up and treated appropriately. Those patients who regressed to a non-dysplastic state were returned to the original referring physician to be followed with annual cytology. Regression to a non-dysplastic state was 30.5 percent at six months, 50.4 percent at 1 1/2 years, 60.5 percent at 2 1/2 years, 70.9 percent at 3 1/2 years, 77.3 percent at 4 1/2 years, 7.8 percent have progressed to a greater degree of cervical dysplasia, removed from follow-up, and treated, and 22 patients have recurred, all with minor degrees of dysplasia. No invasive cancer has been diagnosed in this group of patients. From these results, we conclude that patients with minor degrees of dysplasia associated with HPV can be followed in a routine screening program with the anticipation that the great majority will, over time, convert to a non-dysplastic state. A small number of patients will progress to a higher degree of dysplasia and will be effectively identified, to be referred for colposcopic assessment and appropriate treatment.