HPV status and colposcopy: key predictors in cervical cancer and precancerous lesion diagnosis

Objective: This study aims to evaluate the diagnostic value of high-risk human papillomavirus (HR-HPV) positivity—particularly HPV type 16—together with cytological findings and colposcopic assessment in detecting cervical intraepithelial neoplasia (CIN) and cervical cancer. Materials and Methods: We retrospectively analyzed 781 women who underwent colposcopic examination at a tertiary healthcare center between January 2020 and April 2024. HPV DNA results and cytological evaluations prior to colposcopy were reviewed. Histopathological outcomes from cervical biopsy, endocervical curettage (ECC), and probe curettage (P/C) were examined. Multivariate logistic regression was used to determine the predictors of CIN 2 or more severe lesions. Results: HPV type 16 was found to be a significant independent predictor of CIN2+ lesions, with an odds ratio of 22.36 (p=0.002) compared to HPV-negative individuals. The model demonstrated statistical significance, and the area under the curve (AUC) was calculated as 0.679, indicating moderate diagnostic performance. Other HPV genotypes and unknown HPV status also showed a significant association with higher-grade lesions. Conclusion: HR-HPV, and particularly HPV 16, is strongly associated with the presence of advanced cervical lesions. Women testing positive for HPV 16 should undergo close surveillance and timely colposcopic evaluation by specialists to enable early diagnosis and prevent progression to invasive cervical cancer.