Abstract

Objective: Cervical cancer screening has gradually changed from single cytology to diversification, and HPV testing has steadily become a primary screening method. The purpose of our study is to explore screening strategies suitable for cervical cancer and precancerous lesions in Western Chinese women. Methods: Between January 2010 and December 2020, a total of 7009 patients were diagnosed with high-grade squamous intraepithelial neoplasia (CIN2+) after HPV testing, cytology screening or a combination of both. Results: The mean age of these patients was 40±1 years, the positive rate of human papillomavirus (HPV) was 91.2% and the cytology was 75.1%. The positive rate and negative rate of co-testing were 68.8% and 2% respectively. The positive rate of HPV16/18 was 50.6% and that of HPV52/58/33 was 50.4%, the difference was 0.2%. HPV16/18-positive and cytology-negative infection rate was 54.5%, HPV52/58/33-positive and cytology-negative infection rate was 44.7%, the difference was 9.8%. Conclusion: The common genotypes of HPV infection are HPV16, 58, 52, 33 and 18. Cytology negative patients with HPV52/58/33 positive are recommended to be referred for colposcopy as soon as possible. HPV testing is the primary method of cervical cancer or cervical lesions screening among women in western China, and HPV testing is more sensitive than cytology in predicting cervical lesions.

Keywords: Cervical cancer; High-grade squamous intraepithelial lesions; Cervical cancer screening; HPV; Cytology