Prevalence and Genotype Spectrum of HPV Infection among Women in Xuhui District, Shanghai: Insights for Regional Cervical Cancer Screening Strategies

Abstract Objective: Numerous epidemiological analyses suggest that high-risk HPV infections are a major cause of cervical cancer, with variations in HPV distribution among different countries, regions, and ethnicities. This study aims to reveal the epidemiological characteristics of HPV in Xuhui District, Shanghai, and understand the prevalence and distribution of high-risk genotypes among women in the local area. The findings aim to provide insights for the development of regional cervical cancer screening strategies and the selection of HPV vaccine antigen targets in this specific region. Methods: A retrospective analysis was conducted on HPV test results of 47,423 women tested in the Clinical Laboratory of Shanghai Eighth People's Hospital from January 2017 to April 2023. Real-time quantitative PCR was used to detect HPV DNA genotypes in the molecular laboratory of the department. Statistical analysis was performed using GraphPad Prism 8.0.1 software. The 95% confidence intervals (95% CI) were calculated using binomial distribution analysis, and a two-sided P-value less than 0.05 was considered statistically significant. HPV infection rates and corresponding 95% CIs were calculated for inter-group comparisons. Chi-square tests were used for comparing categorical variables between different age groups, with P < 0.05 indicating statistical significance. Results: Among the 47,423 cervical HPV-DNA test results, the overall infection rate was 18.9%, with single infections accounting for 13.93%, double infections for 3.47%, and multiple infections for 1.5%. The age-specific prevalence of HPV infection showed a "U"-shaped curve, with the highest prevalence observed in the 20-29 age group. The five most common high-risk HPV subtypes in Xuhui District were types 16, 39, 51, 52, 56, and 58 (accounting for 10.3%, 7%, 8%, 20.3%, 6%, and 12%, respectively), with HPV52 having the highest infection rate. Conclusion: This study provides an analysis of the prevalence and genotypes of HPV infections among women in Xuhui District, Shanghai. By assessing viral loads, the study identifies HPV types that are more susceptible, recommending the nine-valent HPV vaccine for women under 45 years old. Additionally, it suggests active participation in HPV screening for older women to reduce the incidence of cervical diseases and deaths caused by cervical cancer. As HPV trends vary worldwide, and genotypes differ in different regions, epidemiological analyses of HPV can accurately and intuitively inform the distribution of region-specific HPV genotypes, contributing to the development of regional cervical cancer screening strategies and the selection of HPV vaccine antigen targets in the area.