Background: Data from Egyptian studies provide widely varying estimates on the prevalence of premalignant
and malignant cervical abnormalities and human papilloma virus (HPVs) infection. To define the prevalence and risk factors of pre-invasive cancer, a community based full-scalecross sectional, household survey including 1000 women aged between 18 and 45 years was conducted.

Methods: The study period was between March 2014 and December 2014. Initially, conventional Papanicolaou (Pap) smears were evaluated using the Bethesda system (TBS), followed by colposcopy and colposcopic guided biopsy (CGB) for all epithelial abnormalities (EA).

Results: EA representing 7.8% (78/1000), were categorized into atypical squamous cell of undetermined significance (ASCUS) (34.6%), atypical glandular cell of undetermined significance (AGCUS) (15.4%),combined ASCUS and AGCUS (2.6%), low grade squamous intraepithelial lesions (SIL) (41%), high grade SIL (5.1%) and invasive lesions (1.3%). CGB of EA (n = 78) showed non neoplastic lesions (46.2%), cervical intraepithelial neoplasia I (CIN) (42.3%), CIN II (6.4%), CINIII (5.1%).

Conclusion: Pre-invasive high grade lesions and invasive cervical carcinoma represent 0.5% and 0.042% respectively in Egyptian women. HPV mostly 16/18 as a risk factor (p < 0.001).