Prevalence and genotype distribution of high-risk HPV in Sarawak, East Malaysia

Cervical cancer remains a significant public health burden in Malaysia, with persistent infection by high-risk papillomavirus (hrHPV) as the primary cause. However, community-based data on HPV prevalence and genotype distribution, particularly in East Malaysia, remain limited. This study aimed to determine hrHPV prevalence, genotype distribution, and associated factors in a large community-based screening cohort in Sarawak.

A retrospective cross-sectional study was conducted between December 2025 and February 2026, using data from women who participated in community-based cervical screening programs across Sarawak. Cervicovaginal samples were collected via cervical swab, liquid-based preparation, or conventional pap smear, and analyzed using the Anyplex™ II HPV HR Detection assay. HrHPV prevalence, genotype distribution, and associations with demographic and clinical factors were analysed using descriptive statistics and logistic regression.

A total of 7,781 participants were included, with an overall hrHPV prevalence of 9.2%. The most frequently detected genotypes were HPV52, followed by HPV68 and HPV56, while HPV16 and HPV18 were less prevalent. Geographic variation was observed across divisions, with prevalence ranging from 3.6% to 11.7%. Ethnic variation was also noted, although differences among major ethnic groups were modest. Of these 286 participants, 82.2% had negative for intraepithelial lesion or malignancy (NILM), while 17.8% had abnormal Pap smear findings.

This study provides important community-based evidence on hrHPV epidemiology in Sarawak, highlighting regional and genotype-specific variation. The predominance of non-16/18 genotypes underscores the importance of continued surveillance to inform vaccination and screening strategies in Malaysia.