Worldwide incidence of cervical lesions: a systematic review

Abstract

We conducted a systematic review summarizing data on incidence of high- and low-grade lesions in women with normal baseline cervical cytology, stratified by age (<30 and ⩾30 years), and baseline human papillomavirus (HPV) infection. Incidence of high- and low-grade lesions in women aged ⩾30 years with a baseline HPV infection increased over follow-up time (5-127 months), although incidence generally remained <10%. Without baseline HPV infection, incidence of high-grade lesions remained low over follow-up time (<5% over 5-122 months). Incidence of high-grade lesions in women aged ⩾30 years with baseline HPV infection appeared similar to that in women aged <30 years. In some women aged <30 years, high-grade lesions can develop relatively shortly after initial HPV infection. We observed an increase in low-grade lesions over time in women aged ⩾30 years with baseline HPV infection, potentially indicative of an HPV infection that is potentially progressing to higher grade lesions.

Fig. 1.

Normal baseline cervical cytology to HSIL/CIN2/3 by age and HPV infection at baseline. CIN, Cervical intraepithelial neoplasia; HPV, human papillomavirus; mixed HPV, studies that include both HPV-positive and HPV-negative women; HSIL, high-grade squamous intraepithelial lesions.

Fig. 2.

Normal baseline cervical cytology to incident LSIL/CIN 1 by age and HPV infection at baseline. CIN, Cervical intraepithelial neoplasia; HPV, human papillomavirus; mixed HPV, studies that include both HPV-positive and HPV-negative women; LSIL, low-grade squamous intraepithelial lesions.