24270198
OBJECTIVE	This study aimed to determine during 36 months of follow-up the ( 1 ) clinical outcomes and ( 2 ) influence of high-risk human papillomavirus ( HPV ) status on the risk of progression to cervical intraepithelial neoplasia 2 + ( CIN 2 + ) , among women with histologically proven CIN 1 .
METHODS	This is an ad hoc analysis of women with CIN 1 within TOMBOLA , a randomized trial of the management of women with low-grade cervical cytology .
METHODS	Women from the colposcopy arm with CIN 1 confirmed on punch biopsies and managed conservatively by cytology every 6 months in primary care were included .
METHODS	Sociodemographic data and a sample for HPV testing were collected at recruitment .
METHODS	Data on the sample women were extracted to calculate the cumulative incidence of CIN 2 + and the performance characteristics of the baseline HPV test .
METHODS	Detection of CIN 2 or worse ( CIN 2 + ) during follow-up or at exit colposcopy was analyzed .
RESULTS	A total of 171 women were included .
RESULTS	Their median age was 29 years .
RESULTS	Fifty-two percent were high-risk HPV positive , 17 % were HPV-16 positive , and 11 % were HPV-18 positive .
RESULTS	Overall , 21 women ( 12 % ) developed CIN 2 + , with a median time to detection of 25 months .
RESULTS	Factors associated with progression to CIN 2 + were presence of HPV-18 ( relative risk = 3.04 ; 95 % CI = 1.09-8 .44 ) and HPV-16 and/or HPV-18 at recruitment ( relative risk = 3.98 ; 95 % CI = 1.60-9 .90 ) .
RESULTS	The sensitivity and specificity of a combined HPV-16 / HPV-18 test for the detection of CIN 2 + during 3 years were 58 % and 78 % , respectively .
CONCLUSIONS	Our results suggest that women with confirmed CIN 1 have low rates of progression to high-grade CIN within 3 years .
CONCLUSIONS	Because the median time to progression was 25 months , conservative management could recommend the next repeat cytology at 2 years .

