Prevalence of human papillomavirus and cervical lesions among elderly women: an unignored challenge to cervical cancer prevention

The prevalence of human papillomavirus (HPV) genotype and cervical neoplasia in women older than 64 years, who are outside the age demographic of cervical cancer screening in China, has been under-researched. This study conducts a retrospective analysis of women from a tertiary hospital in Guangzhou, with the aim to offer valuable insights for cervical cancer prevention and control in elderly women. The study incorporated 876 women, all aged 64 and above. In this age bracket, the prevalence rate of any HPV genotype was found to be 19.27%. The top six HR HPV genotypes were HPV 16, HPV 52, HPV 58, HPV 31, HPV 33, and HPV 18. The persistence rate of any HPV type over a 24-month period in this age group was as high as 33.33%. Among women over 64, around 16.47% of HPV-positive patients were diagnosed with cervical cancer. HPV 58 infection was the most substantial risk factor for histological CIN2+ (OR 3.556; 95% CI, 1.107–11.415; <i>p</i> = 0.032) in women over 64 years of age with HPV-positive/NILM status. In conclusion, the burden of HPV infection is significant among women over 64 years in Guangzhou. Re-evaluation of cervical cancer screening strategies for women after the age of 64 is imperative. Moreover, the HPV 16/18/52/58 genotype model could serve as an alternative triage approach to identify histological CIN2+ among elderly women with HPV-positive/NILM status. Elderly women exhibit an elevated risk of contracting HPV infection and developing cervical lesions.HPV 58 is notably associated with the progression of CIN2+ among women aged above 64 years with HPV-positive/NILM status.HPV 16/18/52/58 genotype model presents an alternative triage approach for identifying CIN2+ among women aged above 64 years with HPV-positive/NILM status. Elderly women exhibit an elevated risk of contracting HPV infection and developing cervical lesions. HPV 58 is notably associated with the progression of CIN2+ among women aged above 64 years with HPV-positive/NILM status. HPV 16/18/52/58 genotype model presents an alternative triage approach for identifying CIN2+ among women aged above 64 years with HPV-positive/NILM status.

针对年龄超出中国宫颈癌筛查适龄人群的64岁及以上女性，其人乳头瘤病毒（human papillomavirus, HPV）基因型分布与宫颈肿瘤患病率的相关研究尚少。本研究对广州某三级医院的876名64岁及以上女性开展回顾性分析，旨在为老年女性的宫颈癌防控提供有价值的参考依据。本研究共纳入876名女性受试者，其中任意HPV基因型的感染率为19.27%；排名前六位的高危（high-risk, HR）HPV基因型依次为HPV16、HPV52、HPV58、HPV31、HPV33及HPV18。该年龄组中，任意HPV型别24个月内的持续感染率高达33.33%。64岁以上女性中，约16.47%的HPV阳性者被确诊为宫颈癌。在HPV阳性且宫颈细胞学检查呈无上皮内病变或恶性病变（negative for intraepithelial lesion or malignancy, NILM）的64岁以上女性中，HPV58感染是组织学确诊宫颈上皮内瘤变2级及以上（cervical intraepithelial neoplasia grade 2 or worse, CIN2+）的最强危险因素（比值比OR=3.556；95%置信区间CI：1.107~11.415；P=0.032）。综上，广州地区64岁以上女性的HPV感染负担较重，亟需重新评估64岁以上女性的宫颈癌筛查策略。此外，HPV16/18/52/58基因型分型模型可作为替代分流方案，用于识别HPV阳性/NILM的老年女性中的组织学CIN2+病变。