Leaflet Details
| Title | Colposcopy and Conservative Management of CIN2 (Cervical Intraepithelial Neoplasia Grade 2) |
| Department | Gynaecology |
| Author(s) | Jennifer Crouch |
| Review Date | November 2026 |
| Next Review | October 2028 |
| Download | A5 Booklet PDF |
| Accessibility Options | Click on the Recite Me button to show our accessibility resources |
Patient Information
Introduction
This leaflet gives you information about CIN2 (Cervical Intraepithelial Neoplasia Grade 2), which means there are some abnormal cells on your cervix.
CIN means there are abnormal cells on your cervix. CIN is caused by the human papillomavirus (HPV). CIN is graded from 1 to 3. CIN1 means mildly abnormal cells, CIN2 means moderately abnormal cells and CIN3 means severely abnormal cells.
About 50% of CIN2 changes go back to normal within 2 years. However, some CIN2 can change into cervical cancer over many years if it is not treated or monitored.
CIN is not cancer. It means that there are abnormal cells on your cervix that could become cancer over time. There is a small risk of this happening. CIN2 can be managed in two ways:
- treatment to remove the abnormal cells (LLETZ) or
- conservative management, which means close monitoring.
Your colposcopist will talk to you about your treatment options. Your results and individual circumstances will be reviewed at a specialist colposcopy multi-disciplinary team (MDT) meeting before a decision is made.
What are my treatment options?
A treatment called loop excision of the transformation zone (LLETZ) has traditionally been offered for CIN2. Your colposcopist will explain LLETZ to you and give you a separate leaflet about it. For some people, LLETZ is still the right choice.
Large loop excision of the transformation zone (LLETZ)
LLETZ stands for Large Loop Excision of the Transformation Zone. It removes a small piece of tissue of abnormal cells from your cervix. The piece is about 1 cm by 1 cm.
What are the benefits of a LLETZ?
It removes the abnormal cells. The abnormal cells are not normally cancer. However, if they are left untreated and unmonitored, they could develop into cancer in the future. The procedure should not be painful, but you may feel some pressure inside your cervix.
What are the Risks of a LLETZ?
The main risks are:
- heavy bleeding
- Infection
LLETZ can also slightly increase the risk of having a premature birth or a miscarriage in the middle of pregnancy (13 to 26 weeks). This is because removing abnormal cells can make the cervix weaker. The risk depends on how much tissue is removed. Removing more than 10 mm may increase the risk of giving birth too early.
There is also a small risk that the cervix may become narrower. This is called cervical stenosis. It may make it harder to get a reliable cervical screening test (smear test) in the future. LLETZ is not linked to an increased risk of infertility.
Conservative Management
Some people with CIN2 can be monitored for up to 2 years. You would have an appointment at the colposcopy clinic every 6 months. You would have cervical screening tests (smear tests) and may also have further cervical biopsies (small pieces of tissue taken from the cervix). This is called conservative management of CIN2.
Studies show that about 50% of CIN2 changes go back to normal without treatment. This can take up to 2 years. Monitoring can help you avoid the risks linked to LLETZ if your CIN2 goes away on its own.
Is conservative management a suitable option for me?
Your colposcopist will talk to you about your options. Conservative management is not suitable for everyone. If you choose this option, your cervical screening test (smear test) and biopsy results will be reviewed at the monthly colposcopy meeting to make sure it is suitable for you. It may be a good option for people who may want to become pregnant in the future. You must attend all your colposcopy appointments. If you cannot attend regularly, conservative management is not suitable for you.
What does conservative management of CIN2 involve?
You will have a colposcopy appointment every 6 months. You will be monitored for up to 2 years.
- If your cervical screening test shows that you are HPV negative, this means that the CIN has gone away. You will then be discharged from the colposcopy clinic. You will continue to have cervical screening tests with your GP in 3 years as part of the NHS cervical screening programme.
- If the CIN2 becomes larger during the 2 years, your colposcopist thinks the CIN2 has changed to a higher grade, or your cervical screening or biopsy results suggest that it has changed to CIN3, your colposcopist will recommend LLETZ treatment.
- If CIN2 is still present after 2 years of conservative management, your colposcopist will recommend LLETZ treatment.
What are the benefits of conservative management?
- For people with a cervix who may want to become pregnant in the future.
- Conservative management avoids risks of LLETZ treatment.
- About half of people with CIN2 will see the abnormal cells go back to normal without treatment.
What are the risks of conservative management?
- Less than 1 in 200 (0.5%) people with CIN2 will develop cervical cancer in the 2 years after diagnosis.
- 1 in 5 (20%) people with CIN2 will develop CIN3 within 2 years. If this happens, you will be offered LLETZ treatment.
- About half (50%) of CIN2 cases will go back to normal without treatment.
What else can I do?
If you smoke, CIN2 is more likely to change to CIN3, which needs treatment. Stopping smoking can make it more likely that conservative management will work and the CIN2 will go away.
NHS Stop Smoking Services can be found here:
https://www.nhs.uk/live-well/quit-smoking/nhs-stop-smoking-services-help-you-quit/
Or you can call the Smokefree National Helpline on 0300 123 1044.
What if I change my mind about conservative management?
You can change your mind at any time. If you are worried or have questions about your treatment, contact the colposcopy department and speak to a member of the specialist team.
Contact Details
If you have any questions, please contact your GP.
Colposcopy Office, Abbey Wing, St Peter's Hospital
Telephone: 01932 722200
Monday to Friday, 8:00am to 4:00pm
If there is no answer, please leave a message and we will return your call as soon as possible.
Colposcopy Clinic: 01932 723984
Further information
- https://www.nhs.uk
- https://www.bsccp.org.uk/
- https://www.nhs.uk/tests-and-treatments/nhs-screening/
- https://eveappeal.org.uk
- https://www.macmillan.org.uk
British Medical Journal, 2018. Tainio et al. Clinical course of untreated CIN 2 under active surveillance: systematic review and meta-analysis. https://www.bmj.com/content/360/bmj.k499
