Human papillomavirus prevalence and genotype distribution among 30,147 screened women and 3,362 cervical cancer patients in China: a retrospective study
Abstract
Background
Persistent infection with high-risk human papillomavirus (HR-HPV) is the primary cause of cervical cancer. Understanding genotype distribution and evaluating screening strategies are essential for effective prevention.
Methods
We retrospectively analyzed cervical cancer screening data from 97,686 women aged 35–64 years in Nanjing (2021–2023). Among these, 30,147 underwent combined cytology and HPV testing and 67,539 TCT alone. HPV genotyping was further performed in 3,362 histologically confirmed cervical cancer cases (3,014 squamous cell carcinomas [SCC] and 348 adenocarcinomas [ADC]) from multiple regions in China.
Results
Combined screening achieved a significantly higher detection rate of abnormalities than TCT alone (13.70% vs. 1.79%, p < 0.001). Overall HPV positivity was 11.19%, increasing with age and peaking at 16.85% in women aged 60–64. The most frequent genotypes were HPV52, HPV58, and HPV16. In cervical cancer cases, HPV was detected in 92.73% of SCC and 59.77% of ADC. The proportion of HPV-negative cancers increased with age, particularly in ADC.
Conclusions
Combined TCT and HPV testing improves detection of cervical lesions compared with cytology alone. The observed age-specific and histology-specific differences in HPV prevalence and genotype distribution emphasize the need for tailored screening strategies, particularly for older women. These findings provide region-specific evidence to support the refinement of cervical cancer prevention and control strategies in China, particularly in contexts with similar demographic and epidemiological characteristics to the study population.