HPV PERSISTENCE AND RISK OF RECURRENCE AFTER TREATMENT OF CERVICAL PRECANCEROUS LESIONS (CIN2+/CIS): SUBSTANTIATION OF THE “TEST OF CURE” APPROACH
Keywords:
cervical cancer, cervical intraepithelial neoplasia, HPV persistence, test of cure, conization, LEEP, thermal ablation, recurrence, surgical margins, HPV vaccination.Abstract
The article analyzes recent international and national studies on the persistence of human papillomavirus (HPV) and the risk of recurrence after treatment of cervical precancerous lesions (CIN2+/CIS). Treated women are shown to have a threefold higher risk of invasive cancer than the general population, persisting for over 20 years; surgical margin status is insufficient for predicting recurrence, while high-risk HPV testing is the most sensitive indicator. HPV-16, postmenopausal status and residual lesions are the main risk factors for persistence. An HPV-based “test of cure” algorithm and a follow-up procedure for high-risk groups are proposed for Uzbekistan.
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