Objective To evaluate if the intraoperative human papillomavirus (IOP-HPV) test has the same prognostic value as the HPV test performed 6 months after treatment of high-grade squamous intraepithelial Lesion (HSIL) to predict treatment failure.

Design Prospective multicenter cohort studySetting: 22 Referral Hospitals in Spain.Population: 1824 women treated for cervical HSIL by Loop Electrosurgical Excision between May 2020 and December 2021

After LEEP an HPV test was performed immediately after excision using a Cobas (83%) or other genotyping test.

Subsequently, pacients were followed with citology and HPV test, 6, 12 and 24 months after treatment.

The IOP-HPV test was compared with HPV test 6 months after procedure and with surgical margins in order to detect residual disease.

Results We described results of the first 992 cases with the 6 month co-test performed. IOP HPV test was feasible (valid result 98,5%). IOP-HPV was positive in 40%, while only 25% at 6 month test. We observed association between the IOP and 6 month HPV test (ChiSquare p= 0.0001), IOP HPV positivity and abnormal citology at 6 months (p=0.063), and positive IOP HPV test and positive surgical margins.(p=0.0001)

Conclusion Preliminary results show that IOP HPV test could be a satisfactory prognostic factor of cervical HSIL treatment result.