Management of Low Grade Cervical Changes (CIN 1)

Introduction

Following your recent visit to the Colposcopy Clinic, the result of your recent biopsy suggests there are low grade cell changes to your cervix which are known as “cervical intraepithelial neoplasia” (CIN 1). This is not cancer. They are changes to the cells that cover the outside of the cervix (squamous cells).

What is CIN?

There are 3 grades of CIN and they relate to how deeply the abnormal cells have gone into the skin covering the cervix:

• CIN 1 (low grade) – up to one third of the thickness of the lining covering the cervix has abnormal cells.

• CIN 2 (high grade) – up to two thirds of the thickness of the lining covering the cervix has abnormal cells.

• CIN 3 (high grade) – the full thickness of the lining covering the cervix has abnormal cells.

What do we know about CIN 1?

Current research suggests that less than 1 in 100 (1%) of patients with CIN1 go onto develop cervical cancer. We also know that CIN 1 can resolve on its own in a significant number of women (approx.80%).

Therefore based on the most up to date evidence, National Guidelines stated that CIN 1 may either be treated or kept under close observation by regular surveillance within the Cervical screening programme.

What will regular surveillance involve?

In the majority of cases we recommend a “conservative management” option for CIN 1 (low-grade abnormality) in the hope that the cells given time will return to normal without active treatment.

Conservative management of CIN 1 is a safe option, however since this involves close observation until your cervical screen test returns to normal, it is important that you attend all of your review appointments. We usually discharge you from the Colposcopy clinic to the care of your GP practice where a further Cervical Screening appointment will be offered in 12 months’ time.

Our ‘local policy’ is to consider treatment if the abnormalities are still persisting after a period of two years or to treat your cervix if the abnormality has increased in grade (to a High Grade change- CIN 2 or CIN 3). Treatment options will be discussed with you at your follow-up appointment if this occurs.

Further Advice:

We hope that you have found the information in this leaflet helpful. If you require any further advice regarding your care, please do not hesitate to ask the clinic staff. They are there to support you and are happy to help with any concerns or anxieties you may have.

Contact numbers:

University Hospital of North Tees

Outpatients Department:
Monday to Friday, 09.00am to 5.00pm
Telephone: 01642 624172

University Hospital of Hartlepool

Outpatients Department:
Monday to Friday, 09.00am to 5.00pm
Telephone: 01429 522865

You can also contact a Specialist Nurse Colposcopist:

Colposcopy Hub:
Monday to Friday, 8.30am to 4.30pm
Telephone 01429 522268

References

Public Health England (2024) NHS Cervical Screening: Programme and Colposcopy Management,  https://www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management

Lellé, R.J., Küppers, V., (2023) Colposcopy: Comprehensive Textbook and Atlas

Further Information:

NHS website:
www.nhs.uk

Cancer Research UK:
www.cancerhelp.org.uk
www.cancerscreening.nhs.uk

Jo’s Cervical Cancer Trust:
www.jotrust.co.uk

The British Society for Colposcopy and Cervical Pathology:
www.bsccp.org.uk

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Team is here to try to resolve your concerns. The office is based at the University Hospital of North Tees if you wish to discuss concerns in person. Our contact details are:

Telephone: 01642 624719
Freephone: 0800 092 0084
Opening hours: Monday to Friday, 9:30am to 4:00pm
Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.
Telephone: 01642 617617

Patient, Public and People with Lived Experience

We are looking for patients to share their experiences of healthcare and to join our Involvement Bank. Working with the patients, carers, families and the general population we support in making decisions about their care can lead to better health outcomes, increased patient satisfaction and a better overall experience. We want to listen and work with you in shaping the future of your healthcare services. To find out more about the Involvement Bank go to our website or contact us at:

Website: www.nth.nhs.uk/about/community/people-with-lived-experience
Email: [email protected]

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team at:

Email: [email protected]