Dergiler / Journal of Medicine and Palliative Care / 2026 / Volume: 7 Issue: 3

The role of colposcopy in the clinical diagnosis and management of cytology-negative, non-16/18 high-risk HPV positive patients

Neçirvan Çağdaş Çaltek(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, JİNEKOLOJİK ONKOLOJİ CERRAHİSİ ANABİLİM DALI)0000-0002-2823-8630
Mahmut Yassa(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, JİNEKOLOJİK ONKOLOJİ CERRAHİSİ ANABİLİM DALI)0000-0002-1176-7608
Gözde Şahin(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, JİNEKOLOJİK ONKOLOJİ CERRAHİSİ ANABİLİM DALI)0000-0003-3067-9125
Başak Özge Kayan(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, JİNEKOLOJİK ONKOLOJİ CERRAHİSİ ANABİLİM DALI)0000-0003-0699-0482
İlteriş Yaman(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, JİNEKOLOJİK ONKOLOJİ CERRAHİSİ ANABİLİM DALI)0000-0002-5563-2887
İlkbal Temel(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, JİNEKOLOJİK ONKOLOJİ CERRAHİSİ ANABİLİM DALI)0000-0002-7337-9977
Sayfa
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Yayın Tarihi
2026-06-25
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Yapay Zeka Hızlı Bakış & Çıkarımlar

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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Especially in populations with low adherence to follow-up, colposcopy may represent an alternative management approach.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Aims: To evaluate the diagnostic and therapeutic role of colposcopy in patients with negative cervical cytology but positive for high-risk human papillomavirus (hrHPV) types other than HPV 16 and 18, in light of current guideline recommendations.
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Temel Bulgular & Veri:Methods: This retrospective study included 428 women aged 21-65 who underwent colposcopy at a tertiary care center between June 2020 and December 2024.
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Sonuç & Katkı:Especially in populations with low adherence to follow-up, colposcopy may represent an alternative management approach.
🔬Tür:Research Article
📍Kapsam:2020 Verileri
⚙️Değişkenler:Negative cytology · colposcopy · cervical intraepithelial neoplasia

Abstract

Aims: To evaluate the diagnostic and therapeutic role of colposcopy in patients with negative cervical cytology but positive for high-risk human papillomavirus (hrHPV) types other than HPV 16 and 18, in light of current guideline recommendations. Methods: This retrospective study included 428 women aged 21-65 who underwent colposcopy at a tertiary care center between June 2020 and December 2024. All patients had negative cytology and tested positive exclusively for high-risk HPV types other than HPV 16/18. Cervical biopsy and endocervical curettage (ECC) were performed during colposcopy. Histopathological evaluations were conducted by experienced gynecologic pathologists using the Lower Anogenital Squamous Terminology (LAST) system. Demographic and clinical data were recorded and analyzed using SPSS version 27. Results: Among the 428 patients, 281 (65.7%) had no dysplasia, 126 (29.4%) had CIN 1, 15 (3.5%) had CIN 2, and 6 (1.4%) had CIN 3. No cases of invasive cervical cancer were detected. ECC results showed CIN 1 lesions in 11 patients (2.6%) and no high-grade lesions. The overall rate of CIN2+ lesions was 4.9%. Most patients with CIN2+ lesions were multiparous, premenopausal, and had a mean age of 40 years. Conclusion: Current ASCCP guidelines recommend follow-up with co-testing after one year for patients with negative cytology and non-16/18 hrHPV positivity. However, the 4.9% rate of CIN2+ lesions observed in this study suggests that immediate colposcopy may be clinically beneficial in this patient group. Especially in populations with low adherence to follow-up, colposcopy may represent an alternative management approach.

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Bu Makaleye Atıf Yap

Çaltek, N. Ç., Yassa, M., Şahin, G., Kayan, B. Ö., Yaman, İ., Temel, İ. (2026). The role of colposcopy in the clinical diagnosis and management of cytology-negative, non-16/18 high-risk HPV positive patients. Journal of Medicine and Palliative Care, Volume: 7 Issue: 3. https://doi.org/10.47582/jompac.1908071

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Kaynakça (26)

  1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-263. doi:10.3322/caac.21834
  2. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87-108. doi:10.3322/caac.21262
  3. Mayadev JS, Ke G, Mahantshetty U, Pereira MD, Tarnawski R, Toita T. Global challenges of radiotherapy for the treatment of locally advanced cervical cancer. Int J Gynecol Cancer. 2022;32(3):436-445. doi:10.1136/ijgc-2021-003001
  4. de Martel C, Plummer M, Vignat J, Franceschi S. Worldwide burden of cancer attributable to HPV by site, country and HPV type. Int J Cancer. 2017;141(4):664-670. doi:10.1002/ijc.30716
  5. Lin S, Gao K, Gu S, et al. Worldwide trends in cervical cancer incidence and mortality, with predictions for the next 15 years. Cancer. 2021; 127(21):4030-4039. doi:10.1002/cncr.33795
  6. Wei F, Georges D, Man I, Baussano I, Clifford GM. Causal attribution of human papillomavirus genotypes to invasive cervical cancer worldwide: a systematic analysis of the global literature. Lancet. 2024;404(10451): 435-444. doi:10.1016/S0140-6736(24)01097-3
  7. Bowden SJ, Doulgeraki T, Bouras E, et al. Risk factors for human papillomavirus infection, cervical intraepithelial neoplasia and cervical cancer: an umbrella review and follow-up Mendelian randomisation studies. BMC Med. 2023;21(1):274. doi:10.1186/s12916-023-02965-w
  8. Small W Jr, Bacon MA, Bajaj A, et al. Cervical cancer: a global health crisis. Cancer. 2017;123(13):2404-2412. doi:10.1002/cncr.30667
  9. Eun TJ, Perkins RB. Screening for cervical cancer. Med Clin North Am. 2020;104(6):1063-1078. doi:10.1016/j.mcna.2020.08.006
  10. Perkins RB, Guido RS, Castle PE, et al. 2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis. 2020;24(2):102-131. doi:10.1097/LGT.0000000000000525 Erratum in: J Low Genit Tract Dis. 2020;24(4):427. doi:10.1097/LGT.0000000000000563
  11. Egemen D, Cheung LC, Chen X, et al. Risk estimates supporting the 2019 ASCCP risk-based management consensus guidelines. J Low Genit Tract Dis. 2020;24(2):132-143. doi:10.1097/LGT.0000000000000529
  12. Li H, Wang X, Geng J, Zhao X. Clinical study of styping detection of human papillomavirus (HPV) infection with microarray from paraffinembedded specimens of cervical cancer and precursor lesions. J Nanosci Nanotechnol. 2015;15(9):6423-6428. doi:10.1166/jnn.2015.10336
  13. Zhang J, Cheng K, Wang Z. Prevalence and distribution of human papillomavirus genotypes in cervical intraepithelial neoplasia in China: a meta-analysis. Arch Gynecol Obstet. 2020;302(6):1329-1337. doi:10.1007/s00404-020-05787-w
  14. Tainio K, Athanasiou A, Tikkinen KAO, et al. Clinical course of untreated cervical intraepithelial neoplasia grade 2 under active surveillance: systematic review and meta-analysis. BMJ. 2018;360:k499. doi:10.1136/bmj.k499
  15. Kalliala I, Anttila A, Pukkala E, Nieminen P. Risk of cervical and other cancers after treatment of cervical intraepithelial neoplasia: retrospective cohort study. BMJ. 2005;331(7526):1183-1185. doi:10.1136/bmj.38663.459039.7C
  16. Guan P, Howell-Jones R, Li N, et al. Human papillomavirus types in 115,789 HPV-positive women: a meta-analysis from cervical infection to cancer. Int J Cancer. 2012;131(10):2349-59. doi:10.1002/ijc.27485
  17. Dai W, Wang T, Chen L, Qiu Z, Chen P, Chen D. Immediate risk of cervical intraepithelial neoplasia and diagnostic value of colposcopy among cytology-negative women with oncogenic HPV: a retrospective study. BMC Womens Health. 2024;24(1):419. doi:10.1186/s12905-024-03258-x
  18. Gu L, Hong Z, Gao H, Qiu L, Di W. Incidence of cervical high-grade squamous intraepithelial lesions and squamous cell carcinoma in women with high-risk human papillomavirus and normal cervical cytology: a retrospective analysis of 1858 cases stratified by age and human papillomavirus genotype. Cytopathology. 2019;30(4):419-425. doi:10.1111/cyt.12717
  19. Perkins RB, Guido RS, Castle PE, et al. 2019 ASCCP risk-based management consensus guidelines: updates through 2023. J Low Genit Tract Dis. 2024;28(1):3-6. doi:10.1097/LGT.0000000000000788
  20. Petousis S, Christidis P, Margioula-Siarkou C, Sparangis N, Athanasiadis A, Kalogiannidis I. Discrepancy between colposcopy, punch biopsy and final histology of cone specimen: a prospective study. Arch Gynecol Obstet. 2018;297(5):1271-1275. doi:10.1007/s00404-018-4714-8
  21. Kabaca C, Giray B, Guray Uzun M, et al. The meaning of high-risk HPV other than type 16/18 in women with negative cytology: is it really safe to wait for 1 year? Diagn Cytopathol. 2021;49(4):480-486. doi:10.1002/dc.24705
  22. Santesso N, Mustafa RA, Wiercioch W, et al. Systematic reviews and meta-analyses of benefits and harms of cryotherapy, LEEP, and cold knife conization to treat cervical intraepithelial neoplasia. Int J Gynaecol Obstet. 2016;132(3):266-271. doi:10.1016/j.ijgo.2015.07.026
  23. Yarandi F, Shirali E, Feizabad E, et al. Cervical intraepithelial neoplasia in non-16/18 high-risk human papilloma virus positive/cytology negative women: an alternative approach in poor resource areas. Taiwan J Obstet Gynecol. 2023;62(2):299-303. doi:10.1016/j.tjog.2022.12.003
  24. Bai A, Xue P, Li Q, Jiang Y, Qiao Y. Diagnostic value of high-risk HPV other than type 16/18 in high-grade cervical neoplasia among cytology-negative women: a multicenter retrospective study. Cancer Med. 2023; 12(13):14794-14805. doi:10.1002/cam4.6109
  25. Zhang J, Zhang D, Yang Z, Wang X, Wang D. The role of human papillomavirus genotyping for detecting high-grade intraepithelial neoplasia or cancer in HPV-positive women with normal cytology: a study from a hospital in northeastern China. BMC Cancer. 2020;20(1): 443. doi:10.1186/s12885-020-06935-w
  26. Wei B, Zhang B, Xue P, et al. Improving colposcopic accuracy for cervical precancer detection: a retrospective multicenter study in China. BMC Cancer. 2022;22(1):388. doi:10.1186/s12885-022-09498-0