{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:57:33Z","timestamp":1790866653005,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cervical cancer is caused by persistent high\u2010risk human papillomavirus (HR\u2010HPV) infection and remains a major global health burden despite available preventive strategies. Most HR\u2010HPV infections and associated low\u2010grade squamous intraepithelial lesions (LSIL) regress spontaneously, yet increasing commercial promotion of topical therapies targeting HPV clearance has emerged in clinical practice. This FIGO\/International Gynecologic Cancer Society (IGCS) Position Statement critically appraises the available evidence on topical treatments for HR\u2010HPV infection and LSIL, and provides evidence\u2010based recommendations for clinical practice and future research. No randomized controlled trial has been adequately designed or powered to evaluate the effect of topical therapies on the prevention of histologically confirmed high\u2010grade squamous intraepithelial lesions (HSIL\/CIN3+). Available studies are characterized by small sample sizes, short follow\u2010up periods, heterogeneous populations, inadequate comparators, and reliance on surrogate endpoints of uncertain clinical relevance, including cytological regression, HPV nondetection, and immunohistochemical markers such as p16\/Ki\u201067. Published meta\u2010analyses reporting statistically significant improvements in virological and cytological surrogates are limited by substantial heterogeneity, publication bias, and follow\u2010up periods under 1\u2009year. Product\u2010specific appraisal of Coriolus versicolor\u2010based and silicon dioxide\/selenite\u2010based vaginal gels reveal additional methodological concerns, including retrospective trial registration, industry funding, and misinterpretation of findings consistent with the spin phenomenon. In the absence of high\u2010quality evidence demonstrating clinically meaningful benefit, FIGO and IGCS do not endorse the routine clinical use of any currently available topical agent for HR\u2010HPV infection or LSIL. Evidence\u2010based surveillance remains the standard of care. Future research should prioritize rigorous trial design with histologically confirmed HSIL\/CIN3+ as the primary endpoint, adequate follow\u2010up of at least 3\u2009years, and appropriate comparators. Clinical management should center on informed shared decision\u2010making and evidence\u2010based counseling, rather than on interventions lacking proven clinical benefit.<\/jats:p>","DOI":"10.1002\/ijgo.71285","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T09:00:49Z","timestamp":1788253249000},"page":"18-25","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>FIGO<\/scp>\n                    \/\n                    <scp>IGCS<\/scp>\n                    statement on the efficacy of topical treatments for high\u2010risk human papillomavirus in preventing\n                    <scp>CIN<\/scp>\n                    3+ lesions"],"prefix":"10.1002","volume":"175","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0093-0438","authenticated-orcid":false,"given":"Ren\u00e9","family":"Pareja","sequence":"first","affiliation":[{"name":"Department of Gynecologic Oncology Instituto 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Medicine and Health Sciences University of Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8634-6261","authenticated-orcid":false,"given":"Ang\u00e9lica","family":"Fletcher","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology Instituto Nacional de Cancerolog\u00eda  Bogot\u00e1 Colombia"},{"name":"Department of Gynecologic Oncology Cl\u00ednica Internacional de Alta Tecnolog\u00eda  Ibagu\u00e9 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4700-9507","authenticated-orcid":false,"given":"Aureli","family":"Torn\u00e9","sequence":"additional","affiliation":[{"name":"Gynecology Department Hospital Cl\u00ednic de Barcelona  Barcelona Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer  Barcelona 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