The Association of Oncogenic HPV Strains with Colposcopic and Histopathological Parameters of Cervical Intraepithelial Neoplasia

BACKGROUND: Cervical cancer is among the most prevalent malignancies impacting women, particularly in low- and middle-income countries. The prompt identification of precancerous lesions is essential, as early care may avert the development of aggressive malignancy. OBJECTIVE: To assess the correlation between oncogenic human papillomavirus (HPV) strains and colposcopic and histological characteristics of cervical intraepithelial neoplasia (CIN). METHODS: A cross-sectional study was conducted from January to December 2024 at the cervical precancerous lesion clinic of Al-Yarmouk Teaching Hospital, Baghdad. Thirty-seven women with abnormal Pap smear results were enrolled in the study. All participants underwent colposcopic examination followed by cervical biopsy for histopathological assessment. High-risk HPV genotypes were detected using polymerase chain reaction (PCR) on liquid-based cytology samples. RESULTS: High-risk HPV infection was detected in most cases, with HPV genotype 56 being the most frequently identified. A subset of patients showed multiple HPV infections. HPV testing demonstrated higher sensitivity for detecting high-grade CIN lesions compared with Pap smear and colposcopy. A significant positive correlation was observed between HPV infection and colposcopic abnormalities. CONCLUSION: Women with abnormal cervical cytology often had oncogenic HPV infections, and HPV testing was more accurate in finding high-grade CIN lesions. These results support the use of HPV testing in addition to standard screening techniques. They also stress the need for bigger multicenter studies to validate the distribution of genotypes and the effectiveness of screening.