The relationship between human papillomavirus genotype distribution and age and the association with high-grade squamous intraepithelial lesions of the cervix or cervical cancer in Jilin Province, China
Using a retrospective cohort of 21,282 individuals aged 10-89 years (634 males, 20,648 females) from Jilin Province between October 2017 and September 2019, we performed HPV genotyping and colposcopy-directed biopsy to delineate age- and genotype-specific infection patterns. High-risk HPV prevalence peaked in adolescence (≤ 18 years) and declined thereafter, whereas low-risk types showed modest age trends (P < 0.001); women had higher rates than men at every age (P < 0.001). HPV16, 18, 33 and 58 were strongly linked to high-grade squamous intraepithelial lesions or cervical cancer, with adjusted ORs (Model II) of 2.41, 0.53, 2.32 and 1.72, respectively. A U-shaped, nonlinear age relationship emerged, with infection risk threshold ages (fold K) at 26, 42, 30 and 37 years. These findings indicate that HPV vaccination and screening should prioritize women ≤ 26 years and re-engage those > 37 years.