Evidence map›Paper›PMID 29487049›Full record

SynthesisBMJ (Clinical research ed.)2018

Clinical course of untreated cervical intraepithelial neoplasia grade 2 under active surveillance: systematic review and meta-analysis.

Karoliina Tainio, Antonios Athanasiou, Kari A O Tikkinen, Riikka Aaltonen, Jovita Cárdenas, Hernándes, Sivan Glazer-Livson, Maija Jakobsson, Kirsi Joronen, Mari Kiviharju and 7 more

Registry-linked trialOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04783805 (Conservative Management of Patients Diagnosed With High-grade Squamous Intraepithelial Lesions), which is not on this map. Cited by 204 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
204citing papers in PubMed, 12 pooled it
23.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04783805 recruitingnot on this mapstarted 2021, after this paper: background citation

Conservative Management of Patients Diagnosed With High-grade Squamous Intraepithelial Lesions (H-SIL) Who Have Pregnancy Intentions: a Prospective Observational Study

TypeobservationalSponsorFundació Institut de Recerca de l'Hospital de la Santa Creu i Sant PauRan2021 to 2027Enrolled200ConditionsCervical Intraepithelial Neoplasia, Squamous Intraepithelial Lesions of the Cervix, Uterine Cervical DysplasiaArmsConservative management with regular follow-up, Conization
3 · Its place in the literature

Who cites it

204 citing papers in PubMed, 12 syntheses or guidelines pooled it, 379 citations in OpenAlex.

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  14. Comparing visual inspection with acetic acid, with and without Lugol's Iodine for triage of HPV self-sample positive women in Ethiopia: a randomized controlled trial.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2024
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144 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 8 institutions in 4 countries.

Karoliina TainioDepartment of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Antonios AthanasiouDepartment of Obstetrics and Gynaecology, University Hospital of Ioannina, Ioannina, Greece.
Kari A O TikkinenDepartments of Urology and Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Riikka AaltonenDepartment of Obstetrics and Gynaecology, Turku University Hospital and University of Turku, Turku, Finland.
Jovita Cárdenas
HernándesNational Center for Health Technology Excellence (CENETEC) Direction of Health Technologies assessment, Mexico City, Mexico.
Sivan Glazer-LivsonDepartment of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Maija JakobssonDepartment of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Kirsi JoronenDepartment of Obstetrics and Gynaecology, Turku University Hospital and University of Turku, Turku, Finland.
Mari KiviharjuDepartment of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Karolina LouvantoDepartment of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Sanna OksjokiDepartment of Obstetrics and Gynaecology, Turku University Hospital and University of Turku, Turku, Finland.
Riikka TähtinenDepartment of Obstetrics and Gynaecology, Kuopio University Hospital, Kuopio, Finland.
Seppo VirtanenDepartment of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Pekka NieminenDepartment of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Maria KyrgiouInstitute of Reproduction and Developmental Biology, Department of Surgery & Cancer, Imperial College, London W12 0NN, UK m.kyrgiou@imperial.ac.uk.
Ilkka KallialaDepartment of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Helsinki University Hospital · FIUniversity of Helsinki · FIUniversity of Turku · FITechnologies pour la Santé · FRImperial College London · GBKuopio University Hospital · FIQueen Mary University of London · GBUniversity Hospital of Ioannina · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo estimate the regression, persistence, and progression of untreated cervical intraepithelial neoplasia grade 2 (CIN2) lesions managed conservatively as well as compliance with follow-up protocols.

designSystematic review and meta-analysis. DATA SOURCES: Medline, Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from 1 January 1973 to 20 August 2016. ELIGIBILITY CRITERIA: Studies reporting on outcomes of histologically confirmed CIN2 in non-pregnant women, managed conservatively for three or more months. DATA SYNTHESIS: Two reviewers extracted data and assessed risk of bias. Random effects model was used to calculate pooled proportions for each outcome, and heterogeneity was assessed using I

main outcome measuresRates of regression, persistence, or progression of CIN2 and default rates at different follow-up time points (3, 6, 12, 24, 36, and 60 months).

results36 studies that included 3160 women were identified (seven randomised trials, 16 prospective cohorts, and 13 retrospective cohorts; 50% of the studies were at low risk of bias). At 24 months, the pooled rates were 50% (11 studies, 819/1470 women, 95% confidence interval 43% to 57%; I

conclusionsMost CIN2 lesions, particularly in young women (<30 years), regress spontaneously. Active surveillance, rather than immediate intervention, is therefore justified, especially among young women who are likely to adhere to monitoring. SYSTEMATIC REVIEW REGISTRATION: PROSPERO 2014: CRD42014014406.

Indexed as

Conservative TreatmentDisease ProgressionFemaleHumansNeoplasm GradingUterine Cervical Dysplasia

Identifiers

PMID29487049
PMCPMC5826010
OpenAlexW2791080877

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.