Early colposcopy in non-16/18 high-risk human papillomavirus positivity with normal cytology

Very few clinical studies have been done to evaluate the potential clinical benefit of utilizing early colposcopy in women with normal Pap smear cytology but positive for high-risk human papillomavirus types other than human papillomavirus 16 or human papillomavirus 18 in a screening population for cervical cancer. The aim of this study was to compare two follow-up strategies and assess the need for colposcopy at the initial visit, based on cytology, human papillomavirus testing, and colposcopic findings at 1 year, among study participants.

In total, 122 women who had negative Pap smears and were positive for high-risk types of human papillomavirus (not human papillomavirus 16/18) were randomly allocated to two groups via simple computer-generated randomization. Notably, one group had a colposcopic examination when they were first diagnosed (61), and the other group had standard Pap/human papillomavirus follow-up without a colposcopic examination (61). All women in both groups had repeat Pap and human papillomavirus testing and a colposcopic examination after 1 year.

Rates of loop electrosurgical excision procedure application were similar between groups (11.5 and 8.2%; p=0.343). So early colposcopy has enabled the treatment of high-grade squamous intraepithelial lesion lesions without increasing the number of loop electrosurgical excision procedures.

In women who had negative cytology yet positive high-risk human papillomavirus types other than human papillomavirus 16/18, there was no statistically significant difference in either high-risk human papillomavirus persistence, abnormal cytology rates, or loop electrosurgical excision procedure requirements at a 1-year follow-up after having their colposcopy performed early vs. delayed assessments. This suggests that these patients can be appropriately managed with risk-based follow-up care.