Predictive determinants of CIN II + lesions in women over 65 years old: the contribution of HPV, colposcopy, and double immunostaining techniques

In 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.