Risk of CIN 2+ in cytologic negative and persistently hr-HPV women according to their hr-HPV genotypes: a retrospective single center analysis

Introduction In january 2020 a different cervical cancer screening program started in Germany. Women above the age of 35 are newly 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, women are referred to colposcopy. As this new approach entails considerable additional work for colposcopists, we analyzed the risk of high-grade cervical intraepithelial neoplasia (CIN 2+) in cytologic negative and persistent hrHPV women according to their hrHPV genotypes.

Methods In this single center retrospective study, women with persistent hrHPV, cytology negative cervical samples from our colposcopy consultation in 2020 and 2021 were analyzed. Patient demographics, hrHPV types, biopsie rates, histological reports, treatment and outcome were collected.

Results During the study, 57 women were enrolled. Most frequent hrHPV genotypes were: hrHPV other, 74%; HPV 16, 18% and HPV 18, 8%. Colposcopy showed no or minor changes in 91% and major changes in 9%. CIN2+ was found in 7 women (12%). Prevalence of CIN2+ by hrHPV genotypes was 30% for HPV16, 20% for HPV18 and 7% for HPVO. A statistically significant dependency between hrHPV and cervical intraepithelial neoplasia was demonstrated (p=0,029).

Conclusion Within this single center study of persistent hrHPV, cytologic negativ samples, women with HPV 16 were significantly 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.

Publication History

Article published online:
11 October 2022