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When performing colposcopy as follow-up for abnormal cervical cytology or presence of high-risk human papillomavirus (HPV), clinicians are often faced with absence of visible lesions, raising the question whether a cervical biopsy should be taken. In a subanalysis of a U.S. study designed to assess human papillomavirus (HPV) diagnostics, colposcopy was performed in >8000 nonpregnant participants aged ≥25 who had abnormal cytology, high-risk HPV, or both. In women with satisfactory colposcopy but no detectable lesions, a single random biopsy of the squamocolumnar junction was performed. Women and colposcopists were blinded to test results.
Among 2796 women who had random biopsies with valid results (mean age, 39.5), biopsy results were normal…