Recurrent cytologic inflammation on cervical smear and risk of low-grade cervical abnormalities in cytology-based screening: A 25-year multicenter cohort study from HPV-resource–limited settings

Recurrent cytologic inflammation was associated with an increased risk of low-grade but not high-grade cervical lesions. These findings suggest that repeated inflammatory cytology reflects a state of cervical epithelial instability or infection-related alteration rather than direct oncogenic progression. In cytology-dominant screening settings prior to widespread HPV DNA-based screening, inflammatory findings may provide contextual information for interpreting patterns of low-grade abnormality detection and highlight the importance of structured screening frameworks during periods of screening transition.