Characteristics of Human Papillomavirus Prevalence and Infection Patterns Among Women Aged 35–65 in Fujian Province, China: A Nine-Year Retrospective Observational Study

Abstract

The assessment of human papillomavirus (HPV) genotype distribution could inform targeted cervical cancer prevention strategies. The epidemiology of HPV genotypes in terms of age and cervical lesions in Fujian Province, China has not been well described. This 9-year retrospective study aimed to delineate the prevalence pattern and trend of HPV genotypes among a large-scale community-based population. Deidentified data were retrieved from the national cervical cancer screening program in China. We included eligible women aged 35–65 years who underwent cervical cancer screening between 2014 and 2022 in Fujian Province. The HPV prevalence within distinct subpopulations was calculated, and trends in HPV prevalence over the years and across age groups were examined using the Cochran-Armitage trend test. A total of 551 604 women (median age 49 years [42, 54]; 0.10% with cervical cancer) were included in this study. The overall HPV prevalence was 11.72% (95% CI: 11.63%–11.80%), with HR-HPV (high-risk HPV) and HPV 16/18 prevalence at 10.02% (9.94%–10.10%) and 1.74% (1.71%–1.78%), respectively. HPV-52, 58, 16, 39, 51, and 68 were the most predominant genotypes in the general population. Nearly all genotypes, except for HPV-39 and 66, showed a decreasing trend in prevalence over the years, while a relatively high prevalence of HR-HPV was observed across all age groups. As lesion severity increased, HR-HPV and 9v-HPV prevalence also increased. Our study underscores the importance of ongoing surveillance of HPV prevalence in China. While the overall decline in HPV infections over the years is encouraging, the relatively high prevalence of HR-HPV warrants continued attention. Strengthening public health strategies—including prioritizing and promoting the current 9-valent vaccination, extending HPV testing and cervical cancer screening to older women where feasible, and developing future vaccines targeting more HR-HPV genotypes—will be crucial in eliminating cervical cancer and HPV-related disease in China and beyond.