Epidemiological study of HPV infection in 40,693 women in Putian: a population study based on screening for high-risk HPV infection

Abstract

Background The infection rate of human papillomavirus (HPV) is high in the coastal regions of China. However, the infection rate among high-risk genotypes of women in Putian City is unknown. Therefore, this study aimed to analyse the epidemiology of high-risk HPV infection among women in Putian and provide a reference for the diagnosis, treatment and vaccination of cervical cancer in this region. Methods The data used were obtained from the Chinese government’s public health program (“Cervical and Breast Cancer Screening Project”). A total of 40,693 female cervical cell exfoliation samples screened for high-risk HPV at the Affiliated Hospital of Putian University from July 2020 to December 2021 were enrolled. DNA was extracted using a fully automatic extractor. Then, 14 high-risk genotypes of HPV were detected by polymerase chain reaction. The characteristics of HPV infection, distribution of high-risk genotypes, infection types and thinprep cytologic test (TCT) classification at different age groups were analysed. Results Among the 40,693 samples, 3899 were infected with HPV, with an infection rate of 9.6%. Accordingly, HPV infection rates gradually increased with age, and statistically significant differences were observed among age groups (χ2 = 74.03, P < 0.01). The infection rates of high-risk HPV52, HPV58 and HPV16 were in the top three and increased with age. Single infection was dominant (84.7%), followed by double infections (12.7%). The cervical cytology of 3899 HPV-positive people can be classified into negative for intraepithelial lesion and malignancy (NILM, 88.0%), atypical squamous cells of undetermined significance (ASC-US, 6.6%), atypical squamous cells—cannot exclude high-grade squamous intraepithelial lesion (ASC-H, 1.4%), low-grade squamous intraepithelial lesion (LSIL, 3.2%) and high-grade squamous intraepithelial lesion (HSIL, 0.8%). HPV16 infection rate increased with increasing severity of cervical cytology (χ2trend = 43.64, P < 0.01), whereas the infection rates of HPV52 (χ2trend = 13.89, P < 0.01) and HPV58 (χ2trend = 13.50, P < 0.01) showed opposite trends. Conclusion The infection rate of female HPV high-risk screening in this region was 9.6% and mainly involved single infections. In addition, HPV16, HPV52 and HPV58 were closely related to the severity of cervical cytology. Effective screening, vaccination and education are needed. The 9-valent vaccine will be effective in reducing cervical pre-invasive disease. It would also be reasonable to state that the rising trend in HPV infection and high grade cytology with age emphasises the need to target older women with screening. Vaccination of younger women (aged ≤ 25) will lay the foundation for better cancer outcomes in the future.

Epidemiology and genotypes analysis of human papillomavirus infection in Beijing, China

“…On the other hand, as the illness advanced, the proportions of HPV39, 51, and 52 steadily decreased. These results were consistent with previous findings [ 10 , 34 ]. In multiple infections, high-risk HPV was less likely to progress to HSIL than in single infections.…”

Correlation analysis of vaginal microecology and different types of human papillomavirus infection: a study conducted at a hospital in northwest China

“…At present, the significance of HR-HPV infection, especially HPV16/18 persistent infection, for cervical cancer has been recognized by most clinicians. Our study showed that the HPV infection rate was 20.27%, a decrease from 22.97% in the same region previously ( 9 ), which may be related to higher education, widespread HPV vaccination, or an increase in average socioeconomic level ( 10 , 11 ). HPV infection rate was higher in women aged <30 and ≥50 years; this was consistent with the previously reported double-peak distribution of HPV infection rates, which was considered to be related to the frequent sexual life, smoking, and oral hormonal contraceptive use in young women ( 11 , 12 ), as well as the changes in sexual behavior, low autoimmunity, and the reactivation of menopausal latent HPV in older women ( 13 , 14 ).…”

The prevalence and genotype distribution of human papillomavirus in central Fujian Province during the COVID-19 pandemic

“…The general infection rates in this study were lower than those in previous surveys in Central Fujian (38.3%, χ2 = 2169.7, P < 0.0005) [ 11 ], Zhejiang (22.3%, χ2 = 600.96, P < 0.001) [ 10 ], and Shanghai (Putuo Hospital) (18.8%, χ2 = 76.9, P < 0.005) [ 12 ] but greater than that in Xi’an (13.5%, χ2 = 52.8, P < 0.01) [ 13 ] and Shandong (16.4%, χ2 = 1.2, P > 0.1) [ 14 ]. The percentage in the healthy group was greater than that in the Putian group (9.6%, χ2 = 92.52, P < 0.005) [ 15 ] and lower than that in the Zhejiang group (13.6%, χ2 = 15.8, P < 0.025) [ 10 ], Fujian group (a cross-sectional study) (16.2%, χ2 = 24.3, P < 0.025) [ 16 ], and Beijing group (11.9%, χ2 = 0.16, P > 0.1) [ 9 ]. The results for the patient group were not significantly different from those for Henan (19.7%, χ2 = 3.91, P > 0.05) [ 17 ] or Guangxi (18.1%, χ2 = 6.3, P > 0.05) [ 18 ] but were lower than those for Beijing (21.0%, χ2 = 20.4, P < 0.025) [ 19 ] and Zhejiang (27.3%, χ2 = 587.8, P < 0.001) [ 10 ].…”