Prevalence of high-risk human papillomavirus infection, associated risk factors, and relationship with cervical precancerous lesions in perimenopausal and older women in an area with high cervical cancer incidence in China

Abstract

Abstract Introduction: Cervical cancer is the fourth most diagnosed cancer globally. Its incidence differs across regions and age groups. Hence, while its incidence is reducing in China, Lueyang County, Shaanxi Province, presents a persistent challenge. Therefore, this study aims to investigate the prevalence of high-risk human papillomavirus (HR-HPV) infection, its influencing factors, and the incidence of cervical-associated lesions in perimenopausal and elderly women (aged 40–65 years) in Lueyang County, Shaanxi Province, China. Additionally, it explored the association between HR-HPV infection and precancerous lesions. Materials and Methods Overall, 2008 women underwent human papillomavirus (HPV) genotyping, while 342 underwent cytological examination. The main outcome indicators were the prevalence of HPV and precancerous lesions and predictors of HR-HPV infection. Results The prevalence of HR-HPV infection among women aged 40–65 years in Lueyang County was 18.43%. Older women exhibited a higher incidence of HPV infection, abnormal ThinPrep Pap Test (TBS) results, and low/high-grade squamous intraepithelial lesions (LSIL/HSIL) (P < 0.05). The most prevalent HR-HPV genotypes in the overall, perimenopausal, and elderly groups were HPV-52, -53, and − 58; HPV-52, -53, and − 16; and HPV-58, -52, and − 53, respectively. The prevalent HR-HPV genotypes in the abnormal TBS results were HPV-16, -52, -33, -58; -16, -52, -58; and-16, -33, and − 52. HPV-16, -18, -33 prevalence increased with increasing lesion severity (P < 0.05). Independent factors influencing HR-HPV were associated with sexual behavior and education level. Conclusions These findings suggest that the elevated rate of abnormal TBS in the older age group may be attributed to the higher prevalence of persistent infection-prone HR-HPV genotypes (HPV-58, -52, and-53), multiple infections, and potent oncogenic HR-HPV genotypes (HPV − 16 and − 33). Additionally, the higher HR-HPV prevalence in older patients may be related to lower education attainment, reduced screening rate, and limited condom usage. Therefore, strategies targeting perimenopausal and older women should prioritize enhancing health awareness, increasing screening rates, and encouraging condom utilization.