【摘要】 目的 评估子宫颈癌筛查史对于子宫颈癌前病变/子宫颈癌的风险，为子宫颈上皮内病变的精细化管理提供参考依据。方法 对2021年9—12月在北京大学第一医院等6家医疗机构2 832例进行阴道镜检查的非妊娠女性子宫颈癌筛查信息进行回顾性分析，主要包括既往子宫颈癌筛查史、本次筛查结果、阴道镜检查情况及活检情况和结果。结果 既往未参加过子宫颈癌筛查女性中，本次高危型人乳头瘤病毒（HR-HPV）阳性且子宫颈细胞学≥ASC-H的患者子宫颈上皮内瘤变（CIN）2+风险为72.2%(95%CI:62.8%～80.4%)，高于既往进行过子宫颈癌筛查的59.6%(95%CI:45.8%～72.4%);CIN3+的风险为47.2%(95%CI:37.5%～57.1%)，高于既往进行过子宫颈癌筛查的31.6%(95%CI:19.9%～45.2%)。子宫颈细胞学筛查结果≥ASC-H患者的CIN2+风险为58.3%(95%CI:43.2%～72.4%)，高于既往进行过子宫颈癌筛查的45.5%(95%CI:24.4%～67.8%);CIN3+的风险为47.9%(95%CI:33.3%～62.8%)，高于既往进行过筛查的19.0%(95%CI:5.4%～41.9%)。结论 定期进行子宫颈癌筛查可以降低子宫颈癌前病变/子宫颈癌的风险，提示阴道镜医生进行检查前，应进一步询问患者既往子宫颈癌筛查情况，结合本次筛查和阴道镜检查结果，能够更好地帮助医生判断子宫颈癌前病变/子宫颈癌的检出风险。更多还原

【Abstract】 Objective To investigate the role of cervical cancer screening history in assessing the risk of cervical precancerous lesions/cervical cancer, and to provide evidence for personalized management of cervical lesions. Methods A total of 2 832 non-pregnant women who underwent colposcopy from September to December in 2021 from 6 hospitals were retrospective analysis. Results The risk of CIN2 + of women without cervical cancer screening history in recent 5 years was 72.2%(95% CI: 62.8% ～ 80.4%) with HPV positive and cytology ≥ ASC-H, higher than 59.6%(95% CI: 45.8% ～ 72.4%) of those with cervical cancer screening history; the risk of CIN3 + also reached 47.2%(95% CI: 37.5% ～ 57.1%), higher than 31.6%(95% CI: 19.9% ～ 45.2%) of those with cervical cancer screening history in recent 5 years. The risk of CIN2+ of women without cervical cancer screening history was 58.3%(95% CI: 43.2% ～ 72.4%) with cytology ≥ ASC-H, higher than 45.5%(95% CI:24.4% ～ 67.8%) for those with cervical cancer screening history in recent 5 years, and 47.9%(95% CI: 33.3% ～ 62.8%) for CIN3 +,higher than the 19.0%(95% CI: 5.4% ～ 41.9%) of women with screening history. Conclusions Regular cervical cancer screening can reduce the risk of cervical precancerous lesions/cervical cancer. It is suggested that the doctor should learn the patients about their previous cervical cancer screening history before colposcopy examination.更多还原