Necessity for immediate referral to colposcopy according to human papillomavirus (HPV) genotypes in negative-cytology women

Objective: This study aimed to investigate the risk of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) according to high-risk (HR) human papilloma virus (HPV) genotypes in women with negative cytology. Methods: A total of 33,531 Korean women who received Pap cytology + HPV co-testing for cervical cancer screening were retrospectively collected. To evaluate the risk of CIN2+ according to HR-HPV genotypes, odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated by a logistic regression model. Results: Of 1337 women with negative Pap result but HR-HPV positive included in the analysis, 160 (12.0%) women were infected by HPV16 or HPV18, while 1177 (88.0%) women were had other HR-HPVs infections. The prevalence of CIN2+ diseases was 3.7% (50 of 1337). In women with HPV16-negative, HPV18-negative, but other HR-HPV-positive (n = 1177), the risk for CIN2+ lesion was significantly increased in women with multiple HR-HPV infections (OR, 5.40; 95% CI, 2.37–12.73), those with HPV58 (OR, 4.83; 95% CI, 2.17–10.74), and those with HPV35 (OR, 4.77; 95% CI, 1.36–16.77). Conclusion: Colposcopy should also be referred to women with multiple HR-HPVs, HPV35, or HPV58 infections, as well as those with HPV16 and HPV18.

Uterine cervical neoplasms; Human papillomavirus; Colposcopy; Cytology

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