ArticleGeburtshilfe und Frauenheilkunde2026
Three Years of Co-Testing 2020-2022: Correlation of Diagnostic Colposcopy with Histology in Cases of Normal Cytology and Persistent High-Risk HPV.
Article in Geburtshilfe und Frauenheilkunde, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Since the introduction of organised cervical cancer screening, abnormal findings have been referred for diagnostic colposcopy in accordance with defined algorithms. The algorithms are primarily based on the HPV test results. A colposcopy is recommended even in cases where the cytology is normal but HPV persists. CIN2+ lesions are also detected in the process. Patients and Methods: All cytological, HPV, and resultant histological test results from the primary screening, recorded in our database between 2020 and 2022, were analysed. The CIN2+ lesions with normal cytology were re-evaluated with regard to the quality of the cell material. Results: A total of 884201 preventive cytology tests and 5002 corresponding histology results from the years 2020-2022 were evaluated. In the normal groups I/II-a, 49 CIN2+ lesions were documented. After revision, 71% (35 cases) remained in group I/II-a. The revision resulted in 16% (8 cases) being reclassified into group 0, and in 12% (6 cases) showing minor discrepancies. Conclusion: Due to the persistence of high-risk HPV, CIN2+ lesions were diagnosed via colposcopy and biopsy despite normal cytology results. These lesions account for a small proportion of the total population. The main reason for the discrepancy was that the cell material was difficult to assess. In the majority of cases where discrepancies were found, but the cell material was otherwise easy to assess, dysplastic cells were absent. This shows that the real problem here lies in the pre-analytical stage. It is possible that the dysplastic areas may not be reached during the swab collection. Systematic reporting of specimen quality and a separate category for HPV-positive/cytologically unremarkable findings in MN III could improve diagnostic management.
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