Human papillomavirus prevalence and genotype distribution among 30,147 screened women and 3,362 cervical cancer patients in China: a retrospective study.

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.