HPV genotype distribution and cervical lesions in Chongqing: a comprehensive analysis of 229,770 females (2015‒2023).

BACKGROUND

Cervical cancer ranks fourth among cancers in women globally, with over 300,000 deaths annually worldwide. Persistent high-risk HPV (HR-HPV) infection is the main cause of cervical cancer. The World Health Organization (WHO) recommends human papillomavirus (HPV) DNA testing for cervical cancer screening. This study analyses the distribution of HPV genotypes and further investigates their association with the severity of cervical lesions, aiming to develop prevention and screening strategies for cervical cancer.

METHODS

A retrospective study was conducted on 229,770 females who underwent HPV DNA testing at The First Affiliated Hospital of Chongqing Medical University between January 2015 and December 2023 to assess the epidemiological distribution of HPV genotypes. In addition, HPV genotypes were further analysed in cervical samples from 749 patients in 2023 who were screened for HPV DNA and had available histological diagnoses. HPV genotyping was performed using capillary electrophoresis analysis.

RESULTS

The overall HPV prevalence was 21.41% among 229,770 patients over the past nine years. Among hr-HPV types, the five most common genotypes were HPV52 (4.55%), HPV16 (3.44%), HPV58 (2.94%), HPV56 (1.33%), and HPV39 (1.32%). Single HPV infection (16.89%) was more common than multiple infections. HPV prevalence exhibited a bimodal distribution, peaking in the under-30 and over-60 age groups. Among 749 HPV-positive patients, the cervical cancer group had the highest median age of 55(interquartile range, 48‒65) years. HPV16 showed the highest prevalence across the different degrees of cervical lesions, followed by HPV52 and HPV58. HR-HPV was found in nearly all cervical cancer cases, with a prevalence of 88.43%, 98.55%, and 97.39% in the low-grade squamous intraepithelial lesion, high-grade squamous intraepithelial lesion, and cervical cancer groups, respectively.

CONCLUSIONS

The distribution of HPV genotypes varies by year and age group. HPV16, HPV18, HPV52, and HPV58 are the predominant genotypes detected in high-grade cervical lesions and cervical cancer groups. Given the high prevalence in these lesions, vaccines incorporating HPV52 and HPV58 may offer enhanced protection. Based on local epidemiological data, adaptable vaccination programs and effective screening are essential for preventing and reducing the risk of cervical cancer.