Immediate Treatment vs Colposcopic Follow-up for Biopsy-Proven CIN 1

Inclusion Criteria: Eligible patients will: have documented CIN 1 by histologic assessment as the highest grade lesion present, have the lesion confined to the cervix and completely visualized, be 16 years or older. Exclusion Criteria: any one of the following will be an excluding characteristic: index Pap smear showing CIN 2, CIN 3 or cancer; index Pap smear shows atypical glandular cells of unknown significance, glandular dysplasia, or malignancy requiring immediate investigation; patients with previously identified CIN 1 by biopsy who are already in a colposcopic surveillance program; unsatisfactory colposcopic exam defined as inability to see the extent of the lesion in the endocervical canal or absence of a lesion on the ectocervix but endocervical curettage shows CIN 1; pregnancy; prior therapy for dysplasia including medical (5FU), surgical (Laser, LEEP) or cryotherapy; prior gynecologic cancer; prior pelvic radiation therapy; inability to attend outpatient follow-up visits because of geographic inaccessibility; other malignancies except non-melanoma skin cancer; immunosuppression due to diseases such as AIDS, organ transplantation, or on immunosuppressive medications such as prednisone, imuran or chemotherapy for diseases like systemic lupus; cognitively impaired or otherwise unable to obtain written informed consent; extension of the CIN 1 lesion to vagina or a separate vaginal lesion showing dysplasia; colposcopically visible condyloma outside of the transformation zone; known allergy to local analgesics; clinically evident vaginitis must be treated and resolved prior to entry on the trial; inability to read and respond in English/French; failure to provide informed consent.