Diagnostic performance of immediate colposcopy among women with high-risk human papillomavirus (HPV) other than HPV 16/18 and normal cytology

Aim Persistent infection with 1 of 14 high-risk genotypes human papillomavirus (HPV) genotypes is the crucial for the development of high-grade cervical cancer precursors. The reassuring management of women with cytology negative, high-risk HPV (HrHPV) positive is important especially after the widespread use of HPV testing either as a cotest. The aim of our study was to compare the colposcopic biopsy results of women with HPV 16/18 with other Hr-HPV genotypes and determine positive predictive values (PPV) for CIN2+ of other HR HPV genotypes. Methods We prospectively had included the women with negative cytology and positive Hr-HPV test other than HPV 16/18. Control group was composed of women with negative cytology positive test results for either HPV 16 or HPV 18. Women with HrHPV positive, cytology negative referred to immediate colposcopy. Results The prevalence of CIN1 and CIN2 is significantly higher in HPV 16/18 group than pooled other HrHPV group (34.1% vs 17.5%, P = 0.01 for CIN 1+; 14.8% vs 5.2%, P = 0.03 for CIN 2+). The prevalence of CIN3 was almost three fold in women with HPV 16/18 (9.1% vs 3.1%). PPV for CIN 2+ was 16.4 (9.1-27.3) for HPV 16, 11.7 (2-37.7) for HPV 18, 20 (3.5-55.7) for HPV 31, 11.1 (0.6-49.3) for HPV 51, 12.5 (0.6-53.3) for HPV 58 and 59. Conclusion We showed the relative high PPV for CIN2+ in OHrHPV other than HPV 16/18 positive group among cytology negative population. HPV 33, 51, 58, 59 and 18 had similar PPV for CIN2+ in basal cytology negative population.

Automated summary

Persistent infection with high-risk genotypes of human papillomavirus is crucial for high-grade cervical cancer precursors. Management of women with cytology negative, high-risk HPV positive is important, especially after the widespread use of HPV testing. The study showed a relatively high positive predictive value for CIN2+ in women with other high-risk HPV genotypes, other than HPV 16/18, among cytology negative population. HPV 33, 51, 58, 59, and 18 had similar positive predictive values for CIN2+ in cytology negative population.