Diagnostic Strategies After Negative Colposcopy in High-Grade Cervical Cytology: A Multicenter Randomized Trial.
J Low Genit Tract DisSep 26, 2026 (epub)
Cirbia Silva Campos, Adriane Cristina Bovo, Bruno Fonseca et al.
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In 30 seconds
This multicenter randomized trial evaluated diagnostic strategies for detecting HSIL+ in women with high-grade cervical cytology and negative colposcopy. Among 257 participants, HPV testing exhibited the highest sensitivity at 94.3%, while the combination of HPV and liquid-based cytology improved specificity to 91.7%. The study suggests that HPV testing followed by liquid-based cytology offers a balanced approach.
Key findings
- HPV testing had a sensitivity of 94.3% and a negative predictive value of 98.6%.
- Liquid-based cytology demonstrated a specificity of 84.9% and accuracy of 84.1%.
- Combining HPV and liquid-based cytology improved specificity to 91.7% with a sensitivity of 77.1%.
- Endocervical brushing increased sensitivity to 100% but reduced specificity to 82.3%.
Why it matters
Understanding the effectiveness of different diagnostic strategies is crucial for clinicians managing women with high-grade cervical cytology and negative colposcopy, as it can influence follow-up care and improve patient outcomes.