Introduction This study analyzed the clinical outcomes of cervical intraepithelial neoplasia 2 (CIN2) patients according to age by histologically reviewing the cervical excision specimen to help in personalized treatment plan for CIN2.

Methods This retrospective cohort study included CIN2 patients who immediately underwent LEEP for the treatment and were followed up for 2 years with cervical cytology and HPV test. Medical records regarding clinical characteristics and histopathologic results were reviewed. We analyzed pathological and clinical outcomes according to age.

Results A total of 164 CIN2 patients were included. The mean age of the patients was 38.5 years. Histological results of cervical excision specimen were: 13 (7.9%) cases in no residual lesion, 31 (18.9%) cases in CIN I, 44 (26.8%) cases in CIN II, 75 (45.7%) cases in CIN III and 1 (0.6%) cases in micro-invasive carcinoma. There were no significant differences in the pathological grade, rates of positive surgical margins and more advanced lesions of the specimens between the age groups. Ten patients (6.1%) had recurrence with cervical dysplasia (8 cases in LSIL, 2 cases in HSIL). The rate of recurrence was not differ between the age groups.

Conclusion/Implications Regardless of age, the proportion of more advanced lesions of cervical excision specimen in CIN2 is relatively high (44.4% to 51.6%). The risk of recurrence of HSIL after conization in CIN2 is very low (1.2%). Therefore, balanced information on the benefits and harms of different treatment options should be provided when an expectant management is adopted in CIN 2 patients.