Updated colposcopy terminology combined with molecular biological research methods as a reliable tool for predicting precancerous lesions of the cervix
Bebneva T.N., Golubenko A.E., Korennaya V.V.
Background. Colposcopy is one of the key diagnostic methods for detecting precancerous lesions and cervical cancer. The updated colposcopy terminology presented at the International Congress in Paris (France) is the result of many years of work by experts from the IFCPC (International Federation for Cervical Pathology and Colposcopy). The detection of high-risk human papillomavirus (HPV) types, namely types 16 and 18, using molecular biological methods (real-time PCR) is a direct indication for colposcopy. HPV is a prerequisite for the development of cervical neoplasia; however, most HPV infections are eliminated spontaneously. The vaginal microbiota is regarded as a key factor determining the outcome of papillomavirus infection.
Materials and methods. This study is a review of the scientific literature involving a targeted search of publications in PubMed, Scopus, Web of Science, and eLibrary.ru databases for the period 2020–2026 using the following keywords: ‘colposcopy’, ‘HPV’, ‘cervical intraepithelial neoplasia’, ‘Lactobacillus’, and ‘vaginal dysbiosis’. The review includes original research, systematic reviews, meta-analyses and clinical guidelines focusing on updated colposcopy terminology and the role of HPV infection diagnosis as a key factor in the development of cervical intraepithelial neoplasia.
Results. Colposcopy, which is used to detect cervical pathology, is considered one of the most accurate diagnostic techniques. It detects precancerous conditions of the cervix, vagina, and vulva, as well as cervical cancer. Given the low reproducibility of colposcopy, standardized terminology enables different doctors to describe the findings with the same degree of accuracy. Consequently, the terminology used in colposcopy is a fundamental tool that makes the method objective and diagnosis accurate and effective. Modern molecular testing methods make it possible not only to carry out extended HPV genotyping (with individual identification of types 16, 18, 45 and combined identification of types 31/33/35/39/51/52/56/58/59/66/68), but also to simultaneously assess the composition of the vaginal microbiota and the predominant species of lactobacilli (typing of L. crispatus, L. jensenii/L. mulieris, L. gasseri/L. paragasseri, L. iners). When used in combination with colposcopy, this approach offers a number of potential benefits: early detection of HPV, improved screening effectiveness, risk assessment of regression or progression of intraepithelial lesions, and optimization of follow-up for patients with high-risk HPV.
Conclusion. The updated colposcopy terminology, when used together with the FEMOFLOR II diagnostic system, provides an optimal tool for a personalized approach to patient management, combining an assessment of the microbiota with Lactobacillus typing and extended HPV genotyping in accordance with current clinical guidelines.
Authors’ contributions. Bebneva T.N. – developing the concept and design of the study, literature analysis; Golubenko A.E. – collecting and processing the material; Bebneva T.N., Golubenko A.E. – writing the text; Korennaya V.V. – editing the text; Bebneva T.N., Golubenko A.E., Korennaya V.V. – approval of the final version of the article.
Conflicts of interest. The authors declare that there are no conflicts of interest.
Funding. The study was conducted without sponsorship.
Generative Artificial Intelligence. In preparing this article, the virtual AI assistant Alice (part of Yandex’s Alice AI family of generative models) was used to translate the abstract. The resulting content was checked, edited and approved by the authors. The authors bear full responsibility for the accuracy of the content of the publication.
For citation: Bebneva T.N., Golubenko A.E., Korennaya V.V. Updated colposcopy terminology combined with molecular biological research methods as a reliable tool for predicting precancerous lesions of the cervix.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (8): 63-72 (in Russian)
https://dx.doi.org/10.18565/aig.2026.231
Keywords
colposcopy
updated colposcopy terminology
human papillomavirus
cervical intraepithelial neoplasia
HPV genotyping
FEMOFLOR
cervical cancer
References
- Bray F., Laversanne M., Sung H., Ferlay J., Siegel R.L., Soerjomataramet I. et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2024; 74(3):229-63. https://dx.doi.org/10.3322/caac.21834
- Fujii T., Taira Y., Flannelly G., Nishizawa H., Tanaka Y. Supporting the global reduction of cervical cancer: challenges in colposcopy practice and training. Front. Oncol. 2025; 15: 1592050. |https://dx.doi.org/10.3389/fonc.2025.1592050
- Arbyn M., Xu L., Simoens C., Martin-Hirsch P.P. Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors (review). Cochrane Database Syst. Rev. 2018; 5(11): CD009069. https://dx.doi.org/10.1002/14651858.CD009069.pub3
- Lei J., Ploner A.E., Elfström K.M., Wang J., Roth A., Fang F. et al. HPV vaccination and the risk of invasive cervical cancer. New Engl. J. Med. 2020; 383(14): 1340-8. |https://dx.doi.org/10.1056/NEJMoa1917338
- Hal M.T., Simms K.T., Lew J.B., Smith M.A., Saville M., Canfell K. Projected future impact of HPV vaccination and primary HPV screening on cervical cancer rates from 2017-2035: example from Australia. PLoS One. 2018; 13(2): e0185332. |https://dx.doi.org/10.1371/journal.pone.0185332
- Zhang Q., Zhao M., Cao D., Wei X., Wang L., Li Y. et al. Assessment of the effectiveness of HPV16/18 infection referred for colposcopy in cervical cancer screening in Northwest of China. J. Med. Virol. 2018; 90(1): 165-71. |https://dx.doi.org/10.1002/jmv.24902
- Drolet M., Bénard É., Pérez N., Brisson M., Ali H., Boily M.C. et al. Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis. Lancet. 2019; 394(10197): 497-509. |https://dx.doi.org/10.1016/S0140-6736(19)30298-3
- Cruickshank M.E., Pan J., Cotton S.C., Kavanagh K., Robertson C., Cuschieri K. et al. Reduction in colposcopy workload and associated clinical activity following human papillomavirus (HPV) catch-up vaccination programme in Scotland: an ecological study. BJOG. 2017; 124(9): 1386-93. |https://dx.doi.org/10.1111/1471-0528.14562
- Bornstein J., Sideri M., Tatti S., Walker P., Prendiville W., Haefner H.K. 2011 terminology of the vulva of the International Federation for cervical pathology and colposcopy. J. Low Genit. Tract Dis. 2012; 16(3): 290-5. https://dx.doi.org/10.1097/LGT.0b013e31825934c7
- 19th Congress of IFCPC. Paris, 4-6 June 2026. https://ifcpcparis2026.com/wp-content/uploads/2026/04/26IFCPC_Abstract%20book.pdf
- Scholefield J.H., Hickson W.G., Smith J.H., Rogers K., Sharp F. Anal intraepithelial neoplasia: part of a multifocal disease process. Lancet. 1992; 340(8830): 1271-3. |https://dx.doi.org/10.1016/0140-6736(92)92961-e
- Santosh A.B., Jones T.J. The epithelial-mesenchymal interactions: insights into physiological and pathological aspects of oral tissues. Oncol. Rev. 2014; 8(1): 239. https://dx.doi.org/10.4081/oncol.2014.239
- Slama J., Adamcova K., Dusek L., Sosna O., Cibula D. Umbilication is a strong predictor of high-grade cervical intraepithelial neoplasia. J. Low Genit. Tract Dis. 2013; 17(3): 303-7. |https://dx.doi.org/10.1097/LGT.0b013e31826f2532
- Mayeaux E.J. Jr., Thomas Cox J., eds. Modern Colposcopy: Textbook and Atlas. 3rd ed. Wolters Kluwer/Lippincott Williams & Wilkins Health, LWW; 2012. 712 p.
- Министерство здравоохранения Российской Федерации. Клинические рекомендации. Рак шейки матки. 2024. Доступно по: https://cr.minzdrav.gov.ru/preview-cr/537_3 [Ministry of Health of the Russian Federation. Clinical guidelines. Cervical cancer. 2024. Available at: https://cr.minzdrav.gov.ru/preview-cr/537_3 (in Russian)].
- McGee A.E., Alibegashvili T., Elfgren K., Frey B., Grigore M., Heinonen A. et al. European consensus statement on expert colposcopy. Eur. J. Obstet. Gynecol. Reprod. Biol. 2023; 290(6): 27-37. https://dx.doi.org/10.1016/j.ejogrb.2023.08.369
- Ye H., Song T., Zeng X., Li L., Hou M., Xi M. Association between genital mycoplasmas infection and human papillomavirus infection, abnormal cervical cytopathology, and cervical cancer: a systematic review and meta-analysis. Arch. Gynecol. Obstet. 2018; 297(4): 1377-87. https://dx.doi.org/10.1007/s00404-018-4733-5
- Liu C., Guo Y., Wang L., Guo R., Lei D. Association between herpes simplex virus type 2 and high-risk human papillomavirus infections: a population study of the National Health and Nutrition Examination Survey, 2009-2016. J. Infect. Dis. 2025; 231(4): e650-8. https://dx.doi.org/10.1093/infdis/jiaf033
- Blanco R., Muñoz J.P. HPV and HCMV in cervical cancer: a review of their co-occurrence in premalignant and malignant lesions. Viruses. 2024; 16(11): 1699. |https://dx.doi.org/10.3390/v16111699
- Инструкция по применению. Набор реагентов для количественной оценки состава микробиоты, качественного и количественного определения ДНК основных патогенных микроорганизмов в репродуктивном тракте женщин методом ПЦР в режиме реального времени ФЕМОФЛОР II. Регистрационное удостоверение № РЗН 2025/24831 от 14.02.2025. М.: ДНК-Технологии; 2025. https://dna-technology.ru/sites/default/files/femoflor_ii_ivd_b_0.pdf [Instructions for use of the reagent kit for quantitative assessment of microbiota composition, qualitative and quantitative detection of DNA of major pathogenic microorganisms in the female reproductive tract by real-time PCR FEMOFLOR II. Registration certificate No. RZN 2025/24831 dated 14.02.2025. Moscow: DNA-Technology; 2025. https://dna-technology.ru/sites/default/files/femoflor_ii_ivd_b_0.pdf (in Russian)].
- Mitra A., MacIntyre D.A., Ntritsos G., Smith A., Tsilidis K.K., Marchesi J.R. et al. The vaginal microbiota associates with the regression of untreated cervical intraepithelial neoplasia 2 lesions. Nat. Commun. 2020; 11(1): 1999. https://dx.doi.org/10.1038/s41467-020-15856-y
- Borgogna J.C., Shardell M.D., Santori E.K., Nelson T.M., Rath J.M., Glover E.D. et al. The vaginal metabolome and microbiota of cervical HPV-positive and HPV-negative women: a cross-sectional analysis. BJOG. Int. J. Obstet. Gynaecol. 2019; 127(2): 182-92. https://dx.doi.org/10.1111/1471-0528.15981
- Leon-Gomez P., Romero V.I. Human papillomavirus, vaginal microbiota and metagenomics: the interplay between development and progression of cervical cancer. Front. Microbiol. 2025; 15: 1515258. https://dx.doi.org/10.3389/fmicb.2024.1515258
Received 28.07.2026
Accepted 05.08.2026
About the Authors
Tamara N. Bebneva, Dr. Med. Sci., Associate Professor, Department of Obstetrics, Gynecology and Reproductive Medicine, Faculty of Continuing Medical Education,Medical Institute, Peoples’ Friendship University of Russia named after Patrice Lumumba, 117198, Russia, Moscow, Miklukho-Maklaya str., 6; obstetrician-gynecologist, Academician I.I. Dedov National Medical Research Center for Endocrinology, Ministry of Health of Russia, 117292, Russia, Moscow, Dmitry Ulyanov str., 11, bebn@mail.ru, https://orcid.org/0000-0003-1095-2008
Aleksei E. Golubenko, gynecological oncologist, CEO and Head, Orel Colposcopy Center, 302040, Russia, Orel, per. Kinoprokatny, 2, https://orcid.org/0000-0001-7197-4812
Vera V. Korennaya, PhD, Deputy Director for Prospective Development, Moscow Scientific and Clinical Center Hospital No. 52, Moscow Healthcare Department, 123182, Russia, Moscow, Pekhotnaya str., 3; Chief Freelance Gynecologist at Moscow Healthcare Department, korennayavv@zdrav.mos.ru, https://orcid.org/0000-0003-1104-4415
Similar Articles
