Time since first sexual intercourse is a good parameter to select women at higher risk for CIN3

Objectives: Low-grade squamous intraepithelial lesion (LSIL) shows higher prevalence in young women, when human papillomavirus (HPV) testing has no consistent role for colposcopy triage. Some women with LSIL may reveal cervical intraepithelial neoplasia grade 2 (CIN2) or grade 3 (CIN3) and, therefore, could be clinically relevant to identify those who are at higher risk for this outcome. This study aimed to evaluate the association of some factors with the histological outcome of women showing cytological LSIL at cervical cancer screening. Materials and Methods: This study included 791 women with cytological LSIL who were referred for immediate colposcopy. Results: higher time since first sexual intercourse (TFI) and non-compliance in the screening were associated with higher prevalence rate for CIN3. Multivariate analysis showed that the CIN3 outcome was associated with TFI ≥10 years considering as a reference < 4 years (odds ratio (OR), 11.11; 95% confidence interval (CI), 2.04–50.00) and 5–9 years (OR, 11.09; 95% CI, 2.04–50.00), and it showed borderline association with non-compliance in screening (OR, 2.48; 95% CI, 0.99–6.17). The age of first sexual intercourse (AFI) was not associated with CIN3 outcome. Conclusions:Women showing LSIL in screening have higher probability to reveal CIN3 if the TFI is ten or more years ago and when they are noncompliant with cervical cancer screening. These women should have immediate colposcopy. These findings presented the question of which parameter is better to define when the woman should begin screening for cervical cancer, age or time since the first sexual intercourse. This study showed that the second parameter could perform better.

Low-grade squamous intraepithelial lesion; Human papillomavirus; Screening; Time of first sexual intercourse.

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