Immediate risk and 5-year cumulative risk of high-grade cervical lesions in high-risk HPV-positive patients with minor cytological abnormalities: a retrospective single-center study in China.

BACKGROUND: Although minor cytological abnormalities predict a low risk of high-grade lesions, their high reporting rates lead to a considerable number of high-grade lesion cases. We carried out this study to analyze the immediate risk and 5-year cumulative risk of high-grade cervical lesions in high-risk human papillomavirus (Hr-HPV)-positive patients with minor cytological abnormalities and to investigate the clinical significance of minor cytological abnormalities during follow-up in our single-center.

METHODS: A total of 1892 patients with positive Hr-HPV, cytology result of atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesion (LSIL) and also underwent colposcopy and biopsy were selected to analyze the immediate risk of high-grade cervical lesions. Besides, a total of 832 patients with baseline histological results of CIN1 or below and 5-year follow-up data available were further used to analyze the 5-year cumulative risk of high-grade cervical lesions.

RESULTS: The immediate incidence rates of CIN3 + in the ASC-US and LSIL groups were 6.27% (63/1005) and 5.64% (50/887), respectively. When CIN3 + was used as the study endpoint, the multivariate logistic regression analysis indicated that there was no significant difference in either the immediate risk or the 5-year cumulative risk of CIN3 + between the ASC-US and LSIL groups.

CONCLUSIONS: In summary, since both the immediate and 5-year follow-up risks for CIN3 + were similar in patients with ASC-US and LSIL, routine follow-up should be performed in minor cytological abnormalities, regardless of whether the cytology result is ASC-US or LSIL. Through the risk assessment of Hr-HPV and cytology combined screening, the 2019 ASCCP guidelines were suitable for cervical cancer screening at our single center.