Long-term risk of cancer following cervical intraepithelial neoplasia: A significant study leveraging Taiwan's national health insurance research database

OBJECTIVES: We used Taiwan's national health insurance research database to conduct a study on the risk of cancer after cervical intraepithelial neoplasia. MATERIALS AND METHODS: The study analyzed data from the Taiwan NHIRD comparing three cohorts: one with precancerous cervical dysplasia (CIN2+ dysplasia), one with mild dysplasia or undetermined dysplasia (non-CIN2+ dysplasia), and one without dysplasia. We excluded patients with index dates before 2001 or after 2016 and adjusted factors to analyze future cancer risks. RESULTS: There were 776, 1248, and 14,421 new cases in the CIN2+ cohort, non-CIN2+ cohort, and cohort without cervical dysplasia, respectively. The competing hazard ratios (95% CI) for the risk of all cancer, cervical or endocervical cancer, malignancy of the anogenital tract, head and neck cancer, respiratory cancer, breast cancer, ovary or uterus cancer, and colon cancer in the CIN2+ and non-CIN2+ cohorts were 2.312 (2.112-2.53) and 1.195 (1.104-1.293), 15.518 (11.936-20.175) and 6.045 (4.713-7.754), 9.369 (4.022-21.821) and 4.451 (2.01-9.856), 2.328 (1.446-3.746) and 1.111 (0.707-1.746), 2.125 (1.622-2.783) and 1.147 (0.896-1.467), 1.794 (1.492-2.158) and 0.98 (0.843-1.139), 0.786 (0.45-1.372) and 1.375 (1.055-1.793), 2.315 (1.832-2.927) and 1.114 (0.885-1.401), respectively. CONCLUSION: This study demonstrates that moderate or severe cervical intraepithelial neoplasia and carcinoma in situ significantly increase long-term cancer risk, even after surgical intervention. Patients with a history of mild or undetermined cervical dysplasia also face heightened cancer risk, emphasizing the need for consistent monitoring.