Genotype-specific prevalence of high-risk human papillomavirus among cytologically normal women in Taiwan
Taiwan launched human papillomavirus (HPV) DNA testing at ages 35, 45, and 65 years to improve cervical cancer screening. However, age- and genotype-specific prevalence data for high-risk HPV (hrHPV) in routine screening populations are limited. We aimed to provide the baseline genotype-specific hrHPV prevalence among cytologically normal women in New Taipei City. We conducted a cross-sectional study between 2022 and 2023 using opportunistic sampling within organized public sector screening services. Women aged ≥30 years underwent co-testing with a Papanicolaou (Pap) smear and HPV DNA using the Roche Cobas test. Descriptive statistics were used to report the hrHPV prevalence, including age distribution and screening history. Among 7,129 women with normal cytology, the overall high-risk HPV prevalence was 4.2 %. HPV-16-only and HPV-18-only accounted for 0.38 % and 0.22 %, with additional co-infections in 0.10 % and 0.03 %, respectively. The combined prevalence of the non-16/18 high-risk genotypes was 3.48 %. Both HPV-16 and HPV-18 were most frequently detected among women aged 45-54 years in terms of case distribution. Age-specific prevalence for overall hrHPV and HPV-16 peaked among women aged 30-44 years and declined significantly with increasing age (p-for-trend = 0.048 and 0.016, respectively). hrHPV prevalence did not differ significantly across Pap-smear screening intervals. Self-reported familiarity with HPV DNA testing was higher in women aged 30-35 years (44.6 %) and lowest in those ≥65 years (12.6 %). This study provided updated hrHPV prevalence estimates that may inform age-based screening strategies and underscored the need for genotype surveillance and risk-based triage approaches.