Neçirvan Çağdaş ÇALTEK, Mahmut YASSA, Gözde ŞAHİN, Başak Özge KAYAN, İlteriş YAMAN, İlkbal Temel YÜKSEL
Journal of Medicine and Palliative Care - 2026;7(3):504-508
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.
