Prevalence of high‐grade cervical intraepithelial neoplasia in women with persistent high‐risk HPV HPV genotypes and negative cytology

摘要

Introduction Primary HPV screening will be implemented into the English Cervical Screening Programme by 2019. Its impact upon women referred to colposcopy, with negative cytology but persistently positive high‐risk HPV (hr HPV ), remains unreported from UK Sentinel sites. HPV primary screening was introduced in Sheffield, UK in April 2013; this paper reports its impact on the service. Methods A retrospective cohort study was performed from June 2014 to July 2016 at the Jessop Wing Colposcopy Unit, Sheffield. UK . Data were obtained from the pathology and colposcopy databases and cross‐referenced with case‐notes and pathology results for women referred with persistently positive hr HPV , cytology negative samples. Patient demographics, hr HPV genotype, biopsy rates, histological diagnoses, management, and outcomes were collected and baseline statistics performed. Results During the study 1076 women were seen. Most frequent hrHPV genotypes were: hr HPV other, 41%; and HPV 16, 33%. The majority (72%) were found to have normal colposcopy; 28% had an abnormal colposcopic assessment (11% low‐grade; 11% high‐grade; 6% inadequate). The majority were discharged (83%) and only 5% underwent LLETZ . No cancers were detected. High‐grade cervical intraepithelial neoplasia ( CIN) was found in 7%; overall risk of CIN 2 was 1/29; 1/30 for CIN 3. Presence of HPV 16 was associated with a significantly higher risk of high‐grade CIN ; 1/9. Conclusion This is the first study to report results for women referred to colposcopy with cytology negative, persistently positive hr HPV . Disease prevalence is low, although women with HPV 16 have a significantly higher likelihood of high‐grade disease compared to other HPV subtypes.