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.