Epithelial lesions of the cervix in patients under 25 years of age on the Isle of Youth
Keywords:
Cervical epithelial lesions, young patients, HPV, cytological screeningAbstract
Cervical epithelial lesions in young women constitute a clinical-epidemiological challenge, primarily linked to the human papillomavirus (HPV). In Cuba, cytological screening begins at age 25, which ignores the high prevalence of HPV and early lesions in this group. Factors such as early sexual debut, IUD use, and long-term hormonal contraception may influence their progression, whose natural history shows high spontaneous regression but also a risk of progression to cancer. A descriptive cross-sectional study was conducted with 556 patients under 25 years of age with cervical lesions treated at the "Héroes del Baire" Hospital (Isla de la Juventud, Cuba; 2013-2024). Epidemiological variables (age, sexual debut, risk factors) and clinical variables (cytological/histological diagnosis, therapeutic management) were analyzed by reviewing medical records and processing in Excel. 63.8% of the lesions were concentrated in women aged 20-24 years, the prevalent risk factors were: IUD (44.4%), hormonal contraception >5 years (35.4%) and smoking (9.0%). 64.0% had no previous cytology due to screening policies. Histologically, high-grade lesions predominated. (HGL) predominated in 50.6% of cases, including carcinoma in situ. The primary management was conization (48.2%), followed by clinical follow-up (26.8%). Lesions in young patients are associated with early sexual debut, high parity, and cofactors such as IUDs/long-term hormonal contraception. Exclusion from screening before the age of 25 favors late diagnosis and progression to HGL. Conization is effective but should be individualized along with options such as local treatment or expectant management, considering the high potential for spontaneous regression.
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