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

Abstract

Objective: This study aimed to investigate the risk of cervical intraep-ithelial neoplasia grade 2 or worse (CIN2+) according to high-risk (HR) human papillomavirus (HPV) genotypes in women with nega-tive cytology. Methods: A total of 33,531 Korean women who received Pap cytology + HPV co-testing for cervical cancer screening were ret-rospectively 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 preva-lence 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 mul-tiple 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.