Prevalence of high‐grade cervical intraepithelial neoplasia in women with persistent high‐risk <scp>HPV</scp> genotypes and negative cytology

Macdonald, Madeleine; Crossley, J.; Ellis, Kay; Dudding, N.; Lyon, Richard Martin; Smith, J. H. F.; Tidy, JA; Palmer, James K.

doi:10.1111/cyt.12516

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…In this study, the HR-HPV infection rate was 6.90% (601/8712), and notably, HPV 52 emerged as the most common genotype, diverging from the findings in other studies [ 17 , 18 , 19 ]. Nevertheless, these results align with previous research [ 20 , 21 ], indicating that HPV 16/18 positivity poses the highest risk for HSIL and lesions of greater severity. This underscores the importance of heightened attention to pregnant women with HPV 16/18 infections compared to those with other HPV genotypes.…”

Section: Discussionsupporting

confidence: 92%

Optimising cervical cancer screening during pregnancy: a study of liquid-based cytology and HPV DNA co-test

Gu,

Hu,

Wei

et al. 2024

Epidemiol. Infect.

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This study assessed the efficacy of ThinPrep cytologic test and human papillomavirus (HPV) co-test in cervical cancer screening during pregnancy. A cohort of 8,712 pregnant women from Ren Ji Hospital participated in the study. Among them, 601 (6.90%) tested positive for high-risk HPV (HR-HPV) and 38 (0.44%) exhibited abnormal cytology results (ASCUS+). Following positive HR-HPV findings, 423 patients underwent colposcopy, and 114 individuals suspected of having high-grade squamous intraepithelial lesion and cervical cancer (HSIL+) underwent cervical biopsy. Histological examination revealed 60 cases of normal pathology (52.63%), 35 cases of low-grade squamous intraepithelial lesion (30.70%), 17 cases of HSIL (14.91%), and 2 cases of cervical cancer (1.75%). The incidence of HSIL+ in HPV 16/18 group was significantly higher than that in non-HPV16/18 group (10.53% vs. 6.14%, P < 0.05). Subsequent evaluation of the clinical performance of cytology alone, primary HPV screening, and co-testing for HSIL+ detection revealed that the HSIL+ detection rate was lowest with cytology alone. These findings suggest that HPV testing, either alone or combined with cytology, presents an efficient screening strategy for pregnant women, underscoring the potential for improved sensitivity in cervical cancer screening during pregnancy. The significantly higher incidence of HSIL+ in the HPV16/18 group emphasizes the importance of genotype-specific considerations.

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Section: Discussionsupporting

confidence: 92%

Optimising cervical cancer screening during pregnancy: a study of liquid-based cytology and HPV DNA co-test

Gu,

Hu,

Wei

et al. 2024

Epidemiol. Infect.

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“…In recent years, it has been established that high-grade cervical neoplasia and invasive cervical cancers are caused by persistent infection with hrHPV [ 6 , 12 ]. Primary HPV screening is significantly more sensitive for high-grade disease prediction than cytology alone [ 13 ]. Long-term data from HPV screening trials indicate a low risk of high-grade CIN in HPV negative and cytologically negative patients [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the quality of colposcopy, only adequate colposcopic settings were performed by two senior consultants. The rate of inadequate colposcopy in patients with persistent hrHPV varies in literature between 0.59% [ 17 ], and 4.8% [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Risk of cervical high-grade squamous intraepithelial neoplasia in cytologic negative and persistently high-risk human papillomavirus positive patients according to genotypes: a retrospective single center analysis

Kipp,

Ulrich,

van Meegen

et al. 2024

BMC Infect Dis

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In January 2020, a different cervical cancer screening program started in Germany. Women above the age of 35 are recommended to have a combined HPV and cytology swab every three years. Showing persistent high-risk human papillomavirus (hrHPV), cytologic negative cervical samples at baseline and after 12 months, patients are referred to colposcopy. Entailing considerable additional workload due to the required colposcopies, we analyzed the risk of high-grade cervical intraepithelial neoplasia (CIN 3) in cytologic negative and persistent hrHPV women according to their hrHPV genotypes.Methods In this single center retrospective study, patients with persistent hrHPV, cytology negative cervical samples from our certified Colposcopy Unit in 2020 and 2021 were analyzed. Patient demographics, hrHPV types, biopsy rates and histological reports were collected.Results During the study, 69 patients were enrolled. Most frequent hrHPV genotypes were: hrHPV other 72.5%; HPV 16, 20.3% and HPV 18, 7.2%. Colposcopy showed no or minor changes in 92.7% and major changes in 7.2%. CIN 3 was found in 7 patients (10.1%). Prevalence of CIN 3 by hrHPV genotypes was 27.3% for HPV16, 20.0% for HPV18 and 7.1% for HPVO. A statistically significant dependency between hrHPV and cervical intraepithelial neoplasia was demonstrated (p = 0.048).Conclusion Within this single center study of persistent hrHPV, cytologic negative samples, patients with HPV 16 were more likely to have high-grade disease compared to other hrHPV subtypes. Larger prospective randomized trials are needed to substantiate our results and obtain adjusted cervical cancer screening time intervals according to the hrHPV genotypes.

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“…The abnormal cytology rate has decreased in Wales following conversion to HPV-based screening in 2018 as hrHPV negative cases do not have cytology triage. Moreover, delayed referral of those with negative cytology potentially prevents overtreatment of regressive SIL as approximately 40% of these women clear HPV in 12 months [23]. In the UK, women would be referred to colposcopy with HPV persistency at 12 or 24 months in the absence of any cytological abnormality.…”

Section: Cytologymentioning

confidence: 99%

“…Macdonald et al [23] reported retrospective data from 1076 women who were hrHPV positive and cytology negative and having further triage with HPV 16/18 typing as part of the Sentinel Sites Pilot. Management depended upon typing with HPV 16/18 seen in colposcopy after first repeat if unchanged at 12 months and with HPVO seen in colposcopy if still unchanged 12 months later.…”

Section: Combined Triage Testsmentioning

confidence: 99%

Options for triage and implications for colposcopists within European HPV-based cervical screening programmes

Leeson

Alalade

Singh

et al. 2021

European Journal of Obstetrics & Gynecology and Reproductiv

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Prevalence of high‐grade cervical intraepithelial neoplasia in women with persistent high‐risk HPV genotypes and negative cytology

Abstract: This is the first study to report results for women referred to colposcopy with cytology negative, persistently positive hrHPV. Disease prevalence is low, although women with HPV16 have a significantly higher likelihood of high-grade disease compared to other HPV subtypes.

Cited by 5 publications

References 13 publications

Optimising cervical cancer screening during pregnancy: a study of liquid-based cytology and HPV DNA co-test

Optimising cervical cancer screening during pregnancy: a study of liquid-based cytology and HPV DNA co-test

Risk of cervical high-grade squamous intraepithelial neoplasia in cytologic negative and persistently high-risk human papillomavirus positive patients according to genotypes: a retrospective single center analysis

Options for triage and implications for colposcopists within European HPV-based cervical screening programmes

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