Estrategias de triaje de lesiones cervicales de alto grado con prueba de VPH positiva

Primary human papillomavirus (HPV) screening is highly sensitive but poorly specific and therefore requires triage. The study therefore aimed to comparatively evaluate triage strategies for identifying high-grade cervical lesions in women with a positive high-risk HPV test. A systematic review guided by PRISMA was conducted covering 2019 to 2025, with a sample of 15 studies. Conventional and liquid-based cytology have high specificity and moderate sensitivity, with similar performance; DNA methylation markers offer greater objectivity and better detection of grade 3 neoplasia; and their combination with cytology or genotyping improves the diagnostic balance. It was concluded that methylation is a promising option that requires standardisation.