The Prevalence of High-grade Cervical Intraepithelial Neoplasia (CIN2+) in Women with Primary High Risk Human Papilloma Virus (hrHPV) Test Positive

Abstract

Background: In Thailand, the current cervical cancer screening program is the primary high risk human papillomavirus (hrHPV) screening test, this method has a high sensitivity for the disease but a low specificity. Therefore, women who test positive for hrHPV infections must be referred for a colposcopy to identify precancerous lesions. Objective: The aim of this study is to determine the prevalence of precancerous lesions CIN2+ and to evaluate the performance of colposcopy in women who have tested positive for hrHPV. Method: We retrospectively reviewed women who tested positive for hrHPV and were referred for colposcopy at the Lopburi Cancer Hospital between 2021 and 2024, to evaluate the prevalence of high-grade cervical intraepithelial neoplasia (CIN2+) in women referred to colposcopy with persistent hrHPV, as well as to determine the positive predictive value of colposcopy in detecting CIN2+ lesions from various types of hrHPV infections. Result: A total of 176 women were referred. Prevalence of CIN2+ was 32.9% and the highest prevalence for persistent HPV type 16 infections 20.5% Additionally, women aged 25-34 showed a significantly higher prevalence of CIN2+. The positive predictive value for colposcopic impression of CIN2+ was 82.7%, (95%CI: 72.4, 93.0). Conclusion: The present study confirms that primary hrHPV cervical cancer screening test increases the detection of CIN2+ but has low specificity as a result, women with hrHPV infection are referred for colposcopic examination to assess precancerous lesions.