CIN I is a common form of cervical precancer. It is a mild precancerous lesion of the cervix. Its management is also done with reference to a variety of factors, sometimes requiring conservative treatment, sometimes medication, and sometimes physical therapy, as explained to you in more detail below. Many patients diagnosed with CIN I find that their doctors are very inconsistent in their treatment decisions for CINI, which causes a great deal of confusion. Why is it so inconsistent? This is affected by a variety of factors: First, the impact of the diagnosis: the same pathology slice, in different hospitals will reach different conclusions. This is partly due to the degree of specialization of hospitals and doctors. On the other hand, CINI itself has poor diagnostic reproducibility. Statistically, a conclusion reached by one specialist is less than half as likely to be confirmed by a group of specialists. It is not surprising then that different hospitals make different treatment decisions. Second, the influence of a variety of factors: (1) the severity of cytology prior to pathologic diagnosis: for example, low-grade lesions are treated differently than high-grade lesions. (2) Satisfactory prior colposcopy: a satisfactory colposcopy gives reliable evidence for treatment, an unsatisfactory colposcopy makes treatment lack certainty, so more aggressive treatment means will be chosen. (3) Age and fertility of the patient: treatment is biased toward conservatism for adolescents younger than 24 years of age and pregnant women. For those who have given birth, treatment is more aggressive. (4) Influence of the duration of the disease: those with a long duration of the disease represent a continuous state of the disease, and treatment tends to be more aggressive. Third, CIN I has a variety of treatment options: observation, with different means of follow-up (TCT once a year, HPV once a year). Physical therapy, known as ABLATION, including laser, electrocautery, freezing, etc. Surgical excision of lesions, so-called EXCISION, including LEEP, various modalities of conization such as laser conization, electrocautery conization, cold knife conization, etc., each with its own advantages and disadvantages. To summarize, the treatment of CINI should be based on the individual situation to choose the best treatment. The 2013 American Society for Cervical and Colposcopic Pathology (ASCCP) guidelines for CINI treatment and follow-up recommendations: (a) Pathologically confirmed CINI, previously a mild abnormality (mild abnormality includes: cytology results for ASCUS, LSIL; HPV 16-positive or 18-positive; persistent infection of HPV for more than one year); a Observation for one year without treatment. b Follow-up TB test at 12 months. c Follow-up TB test at 12 months. d Follow-up CINI treatment. b Review TCT and HPV at 12 months; if both are negative, review annually until 3 years. c Negative at 3 years, then follow normal population screening procedures thereafter. d More than or equal to ASC-US at any one time within 3 years, or positive for HPV at any one time, then colposcopy, and if still CINI and persistent CIN I for at least 2 years, consider treatment. Treatment: Cervical Ablation, (i.e., physical therapy: including laser, electrocautery, etc.) if colposcopy is satisfactory. Partial cervical excision (Excision) is recommended for unsatisfactory colposcopy, or ECC evidence of lesions in the cervical canal, or prior treatment (ii) Pathologically confirmed CINI (or pathologically free of lesions), with prior cytology results of HSIL, or HSIL: a Repeat cytology and HPV assay at 12 and 24 months for those with satisfactory colposcopy and no lesions in the cervical canal: negative on each occasion. Repeat TCT and HPV annually for 3 years for those older than 30 years; repeat cytology assay only for those younger than 30 years. HPV positive at any time during the period, or abnormal cytology, colposcopy. HSIL any time during the period, perform diagnostic cervical Excision (diagnostic excision of the cervix, including LEEP or conization) b Direct diagnostic cervical Excision (diagnostic excision of the cervix, including LEEP or conization). c Review of cytology slides, pathology slides, and colposcopic findings and management based on review. V Our recommendations for the treatment and follow-up of CINI: According to the ASCCP guidelines, in the light of the specific situation in our country (less knowledge of CIN, heavier mental burden, poor follow-up, etc.), and in the light of our own experience, we offer the following opinions on the treatment of CINI: previous cytologic results of low-grade lesions or less, and satisfactory colposcopy (squamous-columnar junction is visible), and young patients with no long-term plan to have children, and good follow-up conditions, can be chosen. If the follow-up condition is good, observation and regular review can be chosen. Interferon therapy may be used in the meantime. Physical therapy (ABLATION) should be considered for those who have already given birth/ or those who have not given birth but intend to have children in the near future, because these cases are not suitable for long-term follow-up. This is because these conditions are not amenable to long-term follow-up. If the previous cytology result is less than a low-grade lesion and colposcopy is unsatisfactory, a cervical tube biopsy is required, and if there is a CINI in the cervical tube, or if CIN I persists despite previous treatment with a different modality, LEEP is performed in the two cases mentioned above. If the previous cytology result is HSIL, or AGC-NOS, and the colposcopy is not satisfactory, then EXCISION can be performed directly; or colposcopy and cytology should be applied to follow up for six months, and then EXCISION can be performed if CINI is still present; or the original cytology, colposcopy, and pathology slides should be reviewed, and treatment should be chosen according to the results of the review. Adolescents younger than 20 years of age diagnosed with CINI are recommended to follow up with cytology and necessary colposcopy every six months, with colposcopy and biopsy if HSIL is detected in the interim, or if there are still ASCUS and higher lesions at two years. After biopsy, if CINII, the tendency is to continue follow-up.Those with CINIII tend to be treated.