Dear Editor, Recently Malagón et al have published an article in the International Journal of Cancer pertaining to a systematic review and meta-analysis study of progression rates to precancer and cancer for human papillomavirus (HPV)-positive, cytology normal women.1 Our study conducted a thorough and well-defined analysis of prospective observational studies and randomized controlled trials, which measured the risk of progressing to histologically ascertain precancerous lesions and cancer for women who are positive for HPV DNA. Our study has valid clinical relevance points, but it is held back because of a few conceptual and methodological issues.