Histological Outcomes and Colposcopic Findings in Patients with Persistent High-Risk Human Papillomavirus Infection Without Major Cytological Findings

A significant proportion of individuals with persistent high-risk human papillomavirus infections and normal or low-grade cytology -who would not typically be referred under cytology-based screening-had a high-grade squamous intraepithelial lesion. Younger age and atypical squamous cells of undetermined significance cytology correlated with elevated risk. Colposcopists should adjust their interpretation and maintain a low threshold for biopsy in this population. The clinical significance of detected high-grade squamous intraepithelial lesions remains an open question.