HPV epidemiologic study in Bengbu, China, involving 123,808 women, 2014-2023

Cervical cancer is largely caused by persistent high-risk human papillomavirus infection, and due to the wide regional variations in HPV type distribution, the long-term epidemiological characterization of HPV infection in China has not yet been sufficiently studied. Cervical cancer screening and the creation of HPV vaccination programs in a given area are significantly influenced by the epidemiological features of HPV infection in that area. In order to provide an epidemiological foundation for the development of an early screening and prevention strategy for cervical cancer, we examined the epidemiological features of HPV infection in a community in the northern part of Anhui Province, China, in this research.

This study examined 123,808 cervical exfoliated cell samples that were taken from female patients at Bengbu Medical University's First Affiliated Hospital between January 2013 and December 2023. An HPV genotyping kit was used for HPV-DNA testing. Age, year, and numerous patterns of HPV infection were taken into consideration when analyzing the prevalence of HPV infection. Differences in prevalence between years and age categories were compared using the χ2 test. Multivariable logistic regression models were used to assess the associations of age, calendar year, and their interaction with the risk of infection by different HPV types, with adjustment for potential confounding factors.

The detection rate of high-risk types (HR-HPV) was 14.24% (17,630/123,808), while the overall prevalence of HPV infection for the 28 HPV genotypes was 17.62% (21,674/123,808). The age-specificity of HPV infection displayed a bimodal distribution with two distinct peaks: 17.39% of people under 25 had an infection, while 21.14% of people between the ages of 60 and 64 had an infection. According to annual distribution statistics, the overall prevalence of HPV infection was low in 2014 and 2015, rapidly increased to 24.19% (2573/10637) in 2016, peaked at 27.04% (2238/8278) in 2017, then decreased annually to a low of 13.44% (2178/16207) in 2019, and remained relatively stable until 2023, when it increased once more to 17.62% (2545/11443). The top five HR-HPV prevalence rates, according to the study of genotype-specific statistics, were HPV-16 (4.01%, 4968/123808), -52 (2.95%, 3651/123808), -58 (2.12%, 2629/123808), -56 (1.05%, 1298/123808), and 51(0.98%,1216/123808). The most prevalent form of infection among the positive cases was HPV, with a single infection rate of 72.85% (12844/17630). Age was positively associated with infection risk for HPV16, HPV31, HPV33, HPV35, HPV52, HPV56, HPV58, and HPV68 (OR = 1.12-1.26). Infection risks for the majority of HPV types declined significantly over time (OR = 0.57-0.82). Significant age-by-year interaction effects were observed for 10 types, indicating heterogeneity in temporal trends across age groups.

This study offers the most comprehensive information on the epidemiological features of HPV infection in Bengbu and even in northern Anhui Province. It also serves as a foundation for the development of cervical cancer prevention and control measures in this area.