Introduction:The cervical cancer screening guideline suggests that females aged 30 to 65 take a combined cytologic and HPV test every 5 years, or a cytologic test alone every 3 years to screen HSIL.Nevertheless, our clinical data indicate incidence of false negative in part of the post-menopausal females’ cytologic test. It is necessary to choose a more appropriate screening scheme for post-menopausal females.Methods: We conducted combined Thinprep cytologic test (TCT) and Cobas4800 HPV-DNA test to a cohort of 1489 female patients. Colposcopy and biopsy were conducted to the patients who showed LSIL or above, positive HPV-16 type or HPV-18 type, or ASCUS accompanied by positive HPV-other type in cytologic tests and HPV tests.Results: Among the 1489 females under combined tests, 321 were menopausal, 1168 were non-menopausal. The proportion of HPV infection were 15.89% (51/321) and 13.96% (163/1168) respectively. There was no significant difference between the two groups (χ2 =0.764, p = 0.382).Verified by cervical biopsy, 12 post-menopausal females and 18 non-menopausal females had HSIL.8 and 18 among post-menopausal and non-menopausal females with HSIL, respectively, had concordant TCT results as the final diagnosis. cytologic tests led to 4 missed diagnosis among the post-menopausal females with HSIL (2 presented normal cytologic results, 2 presented ASCUS which can be repeated in 6 months without further test), giving a missed diagnosis rate as 33.33%,which is statistically significant (p = 0.018).Conclusions:post-menopausal females suffer higher missed diagnosis rate from cytologic test alone than HPV test alone. It serves post-menopausal females better to take preliminary HPV screening than cytologic screening.