Vol 94, No 1 (2023)
Research paper
Published online: 2022-11-17

open access

Page views 3236
Article views/downloads 548
Get Citation

Connect on Social Media

Connect on Social Media

Practical application of modified ASCCP 2019 algorithms in the diagnosis and early detection of cervical pathology

Klaudyna Madziar1, Witold Kedzia1
Pubmed: 36448353
Ginekol Pol 2023;94(1):19-24.


Objectives: We assessed the risk for the high-grade precancerous CIN 2 (+) in women with HSIL and ASC-H depending on HPV status.

Material and methods: A retrospective analysis of results of cervical cancer screening following the current ASCCP recommendations by co-testing (LBC and molecular HPV DNA HR) performed between 2018 and 2022 in the Laboratory of Cervical Pathology, Obstetrics and Gynecology Hospital of Poznan University of Medical Sciences. Patient ages ranged from 22 to 72 years.

Results: The analysis of abnormal results of liquid-based cytology revealed the following: 1 suspicion of cervical carcinoma, 49 HSIL, 97 ASC-H, 95 LSIL, 92 ASCUS, and 4 AGC cases. Histopathological verification of the biopsy samples revealed a total of 288 abnormal results. CIN 2 (+) lesions were found in 127 women. ASC-H was the most common abnormal cytologic finding. Of the 338 molecular test results for HPV DNA HR, 85% were confirmed positive. A positive molecular signal confirming the presence of human papillomavirus on PAP smear was not homonymous with simultaneous histopathological diagnosis of cervical pathology.

Conclusions : There is a high risk for CIN 2 (+) in patients with HSIL and HPV 16 (+) and/or HPV DNA HR (+), as well as ASC-H and HPV 16 (+). HSIL is rarely observed in women with HPV 16 (–). The risk for CIN 2 (+) in women with ASC-H and HPV (–) is low.

Article available in PDF format

View PDF Download PDF file


  1. International Agency for Research on Cancer – IARC, Globocan 2020. Estimated cancer inci-dence, mortality and prevalence worldwide 2020. http://globocan.iarc.fr (14.04.2022).
  2. Dankai W, Khunamornpong S, Siriaunkgul S, et al. Role of genomic DNA methylation in detection of cytologic and histologic abnormalities in high risk HPV-infected women. PLoS One. 2019; 14(1): e0210289.
  3. International Agency for Research on Cancer – IARC, Globocan 2020. Estimated cancer inci-dence, mortality and prevalence in Poland 2020. https://gco.iarc.fr/today/data/factsheets/populations/616-poland-fact-sheets.pdf (16.08.2022).
  4. Habbema D, De Kok IM, Brown ML. Cervical cancer screening in the United States and the Netherlands: a tale of two countries. Milbank Q. 2012; 90(1): 5–37.
  5. ASCCP. https://www.asccp.org/management-guidelines (01.03.2022).
  6. Perkins RB, Guido RS, Castle PE, et al. ASCCP Risk-Based Management Consensus Guidelines Committee 2019. ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. Journal of Lower Genital Tract Disease. 2020; 24(2): 102–131.
  7. https://diag.pl/wp-content/uploads/sites/3/2016/11/HPV_DNA_HR_2016.pdf (22.06.2022).
  8. Jach R, Mazurec M, Trzeszcz M, et al. Cervical cancer screening in Poland in current SARS-CoV-2 pandemic: Interim guidelines of the Polish Society of Gynecologists and Obstetricians and the Polish Society of Colposcopy and Cervical Pathophysiology - a summary January 2021. Ginekol Pol. 2021; 92(2): 165–173.
  9. Kaban I, Bacanakgil BH, Koca S. The comparison of two methods in cervical smear screening - which method is better for smear adequacy rates? Ginekol Pol. 2021; 92(5): 335–338.
  10. PQStat Software. https://pqstat.pl/kontakt (01.03.2022).
  11. Keskin N, Biyik I, Ince O, et al. Evaluation of the consistency ratios of cervical smear, cervical biopsy and conization results. Ginekol Pol. 2021; 92(11): 778–783.