Background: To determine the rate of high-grade cervical intraepithelial lesion and cancer (HSIL+) diagnosis as a result of colposcopic histopathology in patients aged ≥50 years and to investigate the role of cytology, Human Papillomavirus (HPV) test positivity and HPV genotyping in predicting HSIL+. Material and Method: The study included 1102 patients aged ≥50 as study group and 2723 patients aged <50 as control group who were admitted to our colposcopy unit between January 1, 2015 and December 31, 2019 and underwent colposcopy for the first time. The patients with HSIL+ were compared as Cytology group and HPV group in the study group. To evaluate the impact of genotyping HPV positive group was compared in terms of HSIL+ results in subgroups with HPV16/18 and HPV other types positivity. Patients diagnosed with cancer in the same period were compared in terms of age, stage and histology as screening cancer group and symptomatic cancer groups. Results: The rate of cervical cancer in the study group was 2.2% and 1.2 % in the control group. In patients diagnosed with cancer, Federation of Gynecology and Obstetrics stage was ≥ stage IB2 in 57.4% of cases in the symptomatic cancer group and in 18.9% of cases in the screening cancer group. The HPV 16/18 positivity rate in HSIL+ patients were 75.0% and 79.5% in the study and control group, respectively. Conclusion: Cervical cancer rates were found to be high in the group aged ≥ 50 years. HPV genotyping is as effective in patients ≥50 years of age as in those aged < 50 years. Patients diagnosed as a result of screening are caught in the early stages and therefore with increased general life expectancy, the age at which screening is discontinued should be re-evaluated.

背景：为了确定 50 岁以上患者阴道镜组织病理学诊断为高级别宫颈上皮内病变和癌症 (HSIL+) 的比率，并研究细胞学、人乳头瘤病毒 (HPV) 检测阳性和 HPV 基因分型在预测 HSIL+。材料和方法：该研究纳入 2015 年 1 月 1 日至 2019 年 12 月 31 日期间入住我院阴道镜科并首次接受阴道镜检查的 1102 名年龄≥50 岁的患者作为研究组和 2723 名年龄在 50 岁以下的患者作为对照组。研究组将HSIL+患者作为细胞学组和HPV组进行比较。为了评估基因分型 HPV 阳性组的影响，比较了 HPV16/18 和 HPV 其他类型阳性亚组中的 HSIL+ 结果。将同期确诊癌症患者的年龄、分期和组织学作为筛查癌症组和症状性癌症组进行比较。结果：研究组宫颈癌发生率为2.2%，对照组为1.2%。在诊断为癌症的患者中，妇产科联合会分期≥IB2期的有症状癌症组57.4%的病例和筛查癌症组18.9%的病例。在研究组和对照组中，HSIL+ 患者的 HPV 16/18 阳性率分别为 75.0% 和 79.5%。结论：年龄≥50岁的人群宫颈癌发病率较高。HPV 基因分型对 50 岁以上的患者与 50 岁以下的患者一样有效。由于筛查而被诊断出的患者处于早期阶段，因此随着一般预期寿命的增加，应重新评估停止筛查的年龄。