Diagnostic performance and concordance of triage tests for high-grade premalignant cervical lesions

Abstract

Introduction: Early detection of cervical cancer is performed using triage tests such as liquid-based cytology (LBC) and HPV genotyping. Objectives: To evaluate the diagnostic performance and agreement of LBC and HPV genotyping for the triage of high-grade cervical premalignant lesions. Methods: A retrospective cohort study of women aged 30–65 years seen between 2020–2024 at a clinic in Lima, Peru. Diagnostic performance measures and agreement were calculated between LBC and genotyping results (16/18 and pool) and those of high-grade cervical premalignant lesions confirmed by cervical biopsy. Results: A total of 102 women were included, 53.9% of whom presented with high-grade lesions. Positivity rates were 13.7% for LBC and 71.6% for genotyping (16/18=26.5% and pool=45.1%). HPV 16/18 genotyping demonstrated higher sensitivity (32.7%) and agreement (kappa=0.130; p=0.061), whereas LBC showed higher specificity (93.6%). Conclusions: HPV 16/18 genotyping offered better sensitivity and slight agreement as a triage test for high-grade cervical premalignant lesions, while LBC was notable for its specificity.