Predictors of CIN2+ Lesions in Women Referred for Colposcopy: A Five-Year Retrospective Study of 783 Cases
Mehmet Efe Namlı1, Hande Kurt Güven1, Fatma Tunç1, Çağatayhan Öztürk2, Elif Yılmaz11Department of Obstetrics and Gynecology, Ankara Ataturk Sanatoryum Training and Research Hospital, Ankara, Türkiye, 2Department of Gynecologic Oncology, Ankara University School of Medicine, Ankara, Türkiye
Objectives: Colposcopy follows abnormal cervical screening, but high-grade disease is confirmed in only a subset of referred women. We aimed to describe the histopathological yield of colposcopy and identify independent predictors of CIN2+ in a real-world referral population. Methods: We retrospectively reviewed 783 consecutive women who underwent colposcopy over five years and had definitive histopathology from directed biopsy, endocervical sampling, or excision. Cytology, HPV status, and colposcopic impression were evaluated against final histology. CIN2+ included CIN2, CIN3, adenocarcinoma in situ, and invasive carcinoma. Associations were assessed using chi-square/Fisher tests and logistic regression. Results: CIN2+ was detected in 213 women (27.2%). Detection increased with cytological severity, from 8.8% in NILM to 78.9% in HSIL, and was higher with high-grade than with low-grade/negative cytology (68.0% vs. 14.4%; p<0.001). CIN2+ rates were 8.2% in HPV-negative, 16.7% in other high-risk HPV-positive, and 50.2% in HPV 16/18-positive women (p<0.001). High-grade or cancer-suspicious colposcopic impression showed the strongest association (72.7% vs. 11.1%; p<0.001). In multivariable analysis, high-grade or cancer-suspicious colposcopic impression, high-grade cytology, and HPV 16/18 positivity independently predicted CIN2+. Conclusion: One in four referred women had CIN2+. Cytology, HPV genotype, and colposcopic impression should be interpreted together for risk stratification. Keywords: Cervical intraepithelial neoplasia, Colposcopy, Papanicolaou test, Papillomavirus infections, Uterine cervical neoplasms
Cite This Article
Namlı M, Kurt Güven H, Tunç F, Öztürk Ç, Yılmaz E. Predictors of CIN2+ Lesions in Women Referred for Colposcopy: A Five-Year Retrospective Study of 783 Cases. EJMI. 2026; 10(3): 411-417
Corresponding Author: Mehmet Efe Namlı