Yang Xiaohui, Qi Shiyuan, Dai Liyan, Ye Qingjian, Li Xiaomao
Gynecology Department, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of obstetrics and gynecology, Guangzhou Baiyun District Second People's Hospital, Guangzhou, China.
Virol J. 2025 Jun 18;22(1):199. doi: 10.1186/s12985-025-02830-7.
Cervical cancer ranks as the fourth most common cancer among women globally, mainly linked to persistent high-risk HPV infection. In China, significant challenges persist, notably the low rates of HPV vaccination and a substantial case burden. This study retrospectively examined HPV-related cervical cancer data from a tertiary hospital spanning the years 2013 to 2020, to evaluate annual and age-specific incidence trends and offer insights for prevention and treatment strategies.
The retrospective analysis encompassed patients who utilized the gynecological outpatient and inpatient services at the Third Affiliated Hospital of Sun Yat-sen University from 2013 to 2020. HPV genotyping, covering 21 subtypes, was conducted using hybrid capture-based assays. The assessment of cervical biopsy disease etiology was performed by a senior pathologist.
During the study period, a total of 9,194 cases of HPV-positive individuals were identified, among which 479 cases (5.21%) were diagnosed with cervical cancer. From 2013 to 2020, there was a statistically significant decline in the overall incidence of HPV-positive cervical cancer (Z=-4.061, P < 0.001), as well as in the incidence of squamous cell carcinoma (Z=-4.595, P < 0.001). However, the incidence of adenocarcinoma did not exhibit a significant change (Z = 0.118, P = 0.906). Regarding age distribution, a significant decrease in cervical cancer incidence was observed in patients aged 36 to 64 years (Z=-2.658, P = 0.008). In contrast, the incidence remained relatively stable in patients aged 65 years and older (Z = 0.071, P = 0.943). The incidence of squamous cell carcinoma increased with age, peaking at 27.06% in individuals over 65 years.
The decline in HPV-positive cervical cancer cases highlights the success of China's screening and post-2016 vaccination efforts. However, rising HPV infections in younger women and ongoing cancer risks in older groups emphasized the need to broaden adolescent vaccinations, sexual health education, and lifelong screening.
宫颈癌是全球女性中第四大常见癌症，主要与持续性高危型人乳头瘤病毒（HPV）感染相关。在中国，仍存在重大挑战，尤其是HPV疫苗接种率低和病例负担沉重。本研究回顾性分析了2013年至2020年期间一家三级医院的HPV相关宫颈癌数据，以评估年度和特定年龄的发病率趋势，并为预防和治疗策略提供见解。
回顾性分析纳入了2013年至2020年期间在中山大学附属第三医院使用妇科门诊和住院服务的患者。采用基于杂交捕获的检测方法对21种亚型进行HPV基因分型。宫颈活检疾病病因的评估由一名资深病理学家进行。
在研究期间，共确定了9194例HPV阳性个体，其中479例（5.21%）被诊断为宫颈癌。从2013年到2020年，HPV阳性宫颈癌的总体发病率（Z=-4.061，P<0.001）以及鳞状细胞癌的发病率（Z=-4.595，P<0.001）在统计学上均显著下降。然而，腺癌的发病率没有显著变化（Z=0.118，P=0.906）。在年龄分布方面，36至64岁患者的宫颈癌发病率显著下降（Z=-2.658，P=0.008）。相比之下，65岁及以上患者的发病率保持相对稳定（Z=0.071，P=0.943）。鳞状细胞癌的发病率随年龄增长而增加，在65岁以上个体中达到峰值27.06%。
HPV阳性宫颈癌病例的下降凸显了中国筛查和2016年后疫苗接种工作的成功。然而，年轻女性中HPV感染的增加以及老年人群持续存在的癌症风险强调了扩大青少年疫苗接种、性健康教育和终身筛查的必要性。
