Cytology, High-Risk HPV Genotyping, and Histology in Cervical Pathology: A Retrospective Cohort Study

Background/Objectives: Cervical cancer prevention relies on cytology, high-risk human papillomavirus (HR-HPV) testing, and histological confirmation, but these modalities may disagree. We quantified test concordance and determinants of CIN2+ in a specialized gynecologic referral cohort with very low HPV vaccination coverage.

Methods

We retrospectively analyzed 172 women evaluated for suspected or established cervical pathology between 2022 and 2024. Of these, 160 had a definitive HPV result and 130 had histology; histology-based performance analyses used complete cases and are conditional on biopsy verification. Cytology was categorized by the Bethesda system, HR-HPV genotypes were recorded, and histology was dichotomized as CIN2+ versus ≤CIN1.