The Relationship between Cervical Smear and HPV Results with Colposcopic Biopsy Results

CERVICAL SMEAR, HPV AND COLPOSCOPIC BIOPSY

Abstract

Objective: Cervical cancer-related deaths can be significantly reduced by early diagnosis and screening methods. Human papillomavirus (human papillomavirus; HPV) is the main risk factor in the development of cervical cancer. The aim of this study is to investigate the histopathological results of patients who underwent colposcopic evaluation due to abnormal cervical smear results and/or HPV test positivity, and to define the relationship between cervical smear and HPV results and the detection of HSIL and higher lesions.

Method: The study included 1490 patients who underwent colposcopy in Ankara City Hospital Gynecological Oncology Surgery Outpatient Clinic between August 2019 and January 2021.

Results: Cervical smear results were pathological in 59.3% of the study group, and 1.5% of them were interpreted as HSIL. Colposcopic biopsy result was determined as HSIL and above in 59.1% of those whose cervical smear result was HSIL. High-risk HPV type was found to be positive in 69.7% of the patients who had HPV typing. HPV type was found to be type 16 and/or 18 in 44% of these patients. In the presence of type 16 and/or 18, the probability of HSIL and higher lesion increased from 8.1% to 28%.

Conclusion: Cervical smear, especially when performed with HPV typing, is decisive in the identification of HSIL and above lesions. In the presence of HPV 16 and/or 18, approximately one-fourth of those with negative smear results have HSIL and higher lesions. For this reason, it would be appropriate to use co-test for screening cervical pathologies instead of cervical smear alone.