Cervical cancer is a major worldwide health problem. Therefore, regular cervical screening in order to make an early diagnosis can help to prevent cervical cancer, through identifying and treating preinvasive cervical lesions. The aim of this review is to evaluate the correlation between the cytological screening result and the final gold standard histological outcome in the diagnosis of cervical lesions. More specifically, the correlation between high-grade intraepithelial lesion (HSIL) on cytology and histological cervical intraepithelial neoplasia grade 2 or higher (CIN2+) was intended, by calculating the positive predictive value (PPV). PPV is an important value from a clinical point of view. An electronic search was carried out in the electronic databases MEDLINE (through PubMed) and the Cochrane Library (last searched beginning of December 2017), supplemented with the related article feature in PubMed and snowballing. Article selection (predefined inclusion and exclusion criteria) and data extraction were evaluated by two independent reviewers (N.K. and A.V.L.). After identifying 1,146 articles, 27 articles were finally included in this systematic review, representing 28,783 cytological HSIL diagnoses in total. The PPV of HSIL was 77.5% (range: 45.4–95.2%) for the histological diagnosis of CIN2+ and 55.4% (range: 36.4–67.6%) for the diagnosis of CIN3+. In this systematic review, 77.5% of the HSIL-positive women eventually had a CIN2+ diagnosis. The diagnostic value of a cytological HSIL result (conventional or liquid-based cytology) in the diagnosis of CIN2+ lesions is good, but a combination of tests could raise this value.

Introduction: Cervical cancer is a major worldwide health problem. Therefore, regular cervical screening in order to make an early diagnosis can help to prevent cervical cancer. The aim of this retrospective study is to evaluate the correlation between HSIL on cytology and histological CIN2+ in AML, Antwerp and to compare two liquid-based cytological techniques ThinPrep® LBC (TP) and SurePath™ LBC (SP).Methods: 120 women with a HSIL positive cytological smear from 2014 (ThinPrep® LBC) and another 120 from 2010 (SurePath™ LBC) were anonymously randomised out of the AML database, according to predefined in-and exclusion criteria. The Belgian Cancer Registry (CIB and CHP) and the AML database were consulted for histological and cytological data and the researched variables (doctor's speciality, age, HPV status, -genotypes and -persistence) of these 240 women. 184 women, with histological follow-up within one year, out of 240 were included. Statistical analysis was performed using Stata 15.1 (StataCorp, USA). P-values and Odds-ratios were calculated. Results:The CIN2+/HSIL ratio of all included 184 subjects was 75.5% (95%CI=69.3-81.8). The found CIN2+ percentages for TP and SP, were 75.8% (95%CI 67.0-84.6) and 75.3% (95%CI 66.5-84.1) respectively. For all included subjects the variables hrHPV infection (p=0,008; OR=6.97) and HPV16 infection (p=0.004; OR=2.79) were statistically significant for having CIN2+ on histology. Conclusions:The found CIN2+/HSIL ratio of 75.5% in AML, Antwerp is similar to the percentages found in worldwide laboratories. HSIL positive women who are HPV16+ or hrHPV+ are at significant higher risk for invasive cervical disease. No statistically significant difference in CIN2+% was found between the two LBC techniques TP and SP.