ArticleBMC geriatrics2025
Predictive determinants of CIN II + lesions in women over 65 years old: the contribution of HPV, colposcopy, and double immunostaining techniques.
Article in BMC geriatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Cervical cancer screening strategies in women 65 years and older in the human papillomavirus era: A systematic review and meta-analysis of human papillomavirus-based testing and self-sampling approaches.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Pooled it
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Abstract
backgroundCervical intraepithelial neoplasia grade II or higher (CIN II+) is hard to diagnose in women over 65 years of age since age-related anatomical changes take place, and there is a paucity of data. The aim of the study was to identify predictive clinical, virological, colposcopic, and immunohistochemical predictors of CIN II + lesions in this less studied population.
methodsWe retrospectively analyzed 364 postmenopausal women aged ≥ 65 years who underwent colposcopy due to abnormal cytology and/or positive human papillomavirus (HPV) test results. Data included HPV test results, cytology, colposcopic findings, biopsy results, and p16/Ki67 dual immunostaining. Univariate logistic regression was used to determine risk factors associated with CIN II+.
resultsCIN II + lesions were detected in 6.0% of the patients (n = 22). 100% of the CIN II + cases were p16/Ki67 positive and 0% were in negative-staining cases (p < 0.001). CIN II + prevalence was significantly higher among HPV-positive women (9.9%) compared with HPV-negative women (0.7%) (p < 0.001). Among HPV genotypes, HPV 18 was associated with the highest CIN II + rate (20%). Being sexually active (OR: 4.847; p = 0.002), persistent HPV infection (OR: 1.512; p = 0.013), HPV positivity (OR: 16.602; p = 0.006), HPV 18 infection (OR: 5.042; p = 0.033), and pathologic colposcopic findings (OR: 5.503; p = 0.007) were all significantly associated with CIN II + lesions.
conclusionIn women aged ≥ 65 years, CIN II + lesions are strongly linked to HPV positivity, persistent infection, high-risk types such as HPV 18, dual p16/Ki67 positivity, and abnormal colposcopy. This argues for individualized, multimodal cervical screening in elderly women, combining HPV genotype-based risk stratification, biomarker triage (p16/Ki-67), and clinical factors to improve detection and reduce unnecessary procedures.
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