{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T19:26:41Z","timestamp":1793042801157,"version":"4.5.0"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Hamburg-Eppendorf (UKE)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Persistent high-risk HPV infection is associated with an elevated risk for prevalent CIN II\u2009+\u2009despite normal cytology (NILM). Our study aims to evaluate the clinical relevance of a persistent high-risk HPV infection without cytologic changes in women aged\u2009\u2265\u200965 and to determine the role of colposcopy for triage in these cases.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>211 patients aged\u2009\u2265\u200965 with persistent HPV infection and normal cytology (NILM) who presented for colposcopy at five certified centers between January 2021 and April 2022 were included in the study. Colposcopic findings, HPV subtypes, when available, histology and p16\/Ki67 staining were assessed as well as individual risk factors such as smoking and previous HPV-related surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>87.7% (185\/211) of the included women had a type 3 transformation zone. In 83.4% (176\/211), a biopsy was taken [thereof 163 endocervical curettages (ECC)]. In 35\/211 women (16.6%), sampling was not possible during colposcopy due to an inaccessible cervix, pain during examination or obliteration of the cervical canal. Out of these, 6 women received a diagnostic excision. CIN II\u2009+\u2009was detected in 10.6% of all histologies (excisional or biopsy) (20\/182). 50% of the women with a CIN II\u2009+\u2009where HPV 16 positive. Taking only the women diagnosed with CIN III or AIS into account, (<jats:italic>n\u2009=\u2009<\/jats:italic>12) 75% were HPV 16 positive. Interestingly, 80% of the women with CIN II\u2009+\u2009had an abnormal cytology when repeatedly taken during colposcopy, vice versa an endocervical lesion was diagnosed in 53% of women with abnormal repeat cytology (27\/51).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The prevalence of CIN II\u2009+\u2009in women is\u2009\u2265\u200965 with persistent hr HPV infection but NILM cytology is similar to that in younger women. However, more than 85% of the women have a type 3 transformation zone. Colposcopy is, therefore, not helpful to diagnose the women who need treatment in this age group.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00404-023-07281-5","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T17:04:22Z","timestamp":1702314262000},"page":"1561-1567","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The use of colposcopy for triage in HPV-positive women aged 65\u00a0years and older"],"prefix":"10.1007","volume":"309","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1134-4903","authenticated-orcid":false,"given":"E.","family":"Kuenkel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Jaeger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Bohlmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Bergauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Kuehler-Obbarius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Prieske","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Maass-Poppenhusen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Schmalfeldt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Woelber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"issue":"7","key":"7281_CR1","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1016\/S1470-2045(11)70145-0","volume":"12","author":"HA Katki","year":"2011","unstructured":"Katki HA et al (2011) Cervical cancer risk for women undergoing concurrent testing for human papillomavirus and cervical cytology: a population-based study in routine clinical practice. 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