Risk Profile of High-grade Cervical Lesions and Cervical Cancer Considering the Combination of Cytology, HPV Genotype, and Age among Women Undergoing Colposcopy

• Published in: Revista Brasileira de ginecologia e obstetrícia Vol. 45; no. 11; pp. e689 - e698
• Main Authors: Possati-Resende, Júlio César, Fritsch, Thais Zilles, Souza, Karen Cristina Borba
• Format: Journal Article
• Language: English
• Published: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Thieme Revinter Publicações Ltda 01.11.2023; Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
• Subjects: colposcopy; OBSTETRICS & GYNECOLOGY; Original; papillomavirus infections; risk; squamous intraepithelial lesions of the cervix; uterine cervical neoplasms; lesão escamosa intraepitelial cervical; colposcopy; uterine cervical neoplasms; squamous intraepithelial lesions of the cervix; papillomavirus infections; infecções por papillomavirus; neoplasias do colo do útero; risk; colposcopia; risco
• ISSN: 0100-7203; 1806-9339; 1806-9339
• DOI: 10.1055/s-0043-1772483

Abstract Objective The present study aims to establish a risk profile for high-grade cervical lesions and cervical cancer (CIN2 + ) in women undergoing colposcopy at the Hospital do Câncer de Barretos, through the analysis of Human Papillomavirus (HPV) infection, cervical cytology, and patient's age. Methods Retrospective cross-sectional study based on a computerized database of women aged ≥ 18 years old who underwent colposcopy at the Prevention Department of the Hospital do Câncer de Barretos from 2017 to 2019. Results A total of 3,411 women were included, 58.0% were positive for high-risk-HPV test, with a higher prevalence of CIN2+ for HPV16 (30.3%) and other HPV (45.0%). Cytological findings that suggest invasive cervical cancer (squamous cells or adenocarcinoma), regardless of the status of HPV test, showed 100% diagnosis of CIN2 + , while atypias that suggest high-grade lesions, HSIL and ASC-H, positive for HPV test, showed in 86 and 55.2%, respectively, diagnosis of CIN2 + . ASC-H cytological results among women aged > 40 years old and negative HPV were mainly associated with benign findings. We observed that ≤ CIN1 has a higher prevalence among older women with negative HPV, while for high-grade lesions there is an increase among young women HPV16- and/or 18-positive. In cancer diagnosis, we observed a predominance of HPV 16/18 regardless of the age group. Conclusion The highest risks of precursor lesions and cervical cancer were found among women with positive HPV 16/18 tests and severe cytological atypia in population screening tests. In addition, cytological findings of ASC-H HPV negative in women > 40 years old usually represent benign findings in histological investigation.