Abstract
ObjectiveTo assess the prevalence and distribution of HPV genotypes among Chinese Han women, and to explore the risk of high-grade cervical lesions associated with individual hr-HPV genotypes.MethodsGenotyping and histopathology data from the Chinese Multi-Center Screening Trial (CHIMUST) and its pilot screening trial, from 6 regions across mainland China, were re-analyzed. The data from physician- and self-collected samples from 10,867 Chinese Han women (ages 30–69) were used to determine the prevalence and distribution of hr-HPV and to explore the risk association between hr-HPV genotypes and precancerous lesions.Results9.2% of the study population tested hr-HPV positive in physician-collected sample. The prevalence varied regionally from the lowest in Guangdong (6.3%) to the highest in Inner Mongolia (13.0%). The most prevalent genotypes found were HPV-52 (21.7%), HPV-16 (19.2%), HPV-58 (15.0%), HPV-39 (8.9%), and HPV-51 (8.2%). The overall odds ratios for CIN2+ and CIN3+ for the presence of HPV-16 was 58.6 (95% CI 39.2–87.5) and, 91.6 (95%CI 54.3–154.6), respectively and remained the highest odds ratio for CIN3+ in all 6 regions.ConclusionGeographical variation exists in the prevalence and distribution of hr-HPV in mainland China. HPV-16/52/58 were the most prevalent genotypes, and HPV-16 had the highest risk for high-grade cervical lesions.Trial registrationCHIMUST, Registration number: ChiCTR-EOC-16008456. Registered 11 May 2016.
Highlights
Cervical cancer is ranked as the fourth most common cancer in women, with an estimated of 570,000 newly diagnosed cases and over 310,000 deaths in 2018 worldwide, more than three quarter of these are from low-income and middle-income countries (LMICs) [1]
The data from the Chinese Multi-Center Screening Trial (CHIMUST) and the Shenzhen Pilot Screening Trial which together enrolled 11, 143 women from 6 regions in northern, central and southern mainland China, were re-analyzed to assess the prevalence and distribution of HPV genotypes among Chinese Han women, and to explore the risk of high-grade cervical lesions associated with individual high-risk human papillomavirus (hr-HPV) genotypes
1754 of non-Han ethnicity, 40 Seq HPV testing failures and 236 Seq HPV positives who did not return for colposcopy were excluded
Summary
Cervical cancer is ranked as the fourth most common cancer in women, with an estimated of 570,000 newly diagnosed cases and over 310,000 deaths in 2018 worldwide, more than three quarter of these are from low-income and middle-income countries (LMICs) [1]. Persistent high-risk human papillomavirus (hr-HPV) infection by certain types is the main cause of cervical cancer and cervical intraepithelial neoplasia [3]. The virus prevents cellular apoptosis by degrading p53 which contributes to the accumulation of genetic mutations. This leads to immortalization through viral protein E6 and stimulates cell proliferation by degrading the. The data from the Chinese Multi-Center Screening Trial (CHIMUST) and the Shenzhen Pilot Screening Trial which together enrolled 11, 143 women from 6 regions in northern, central and southern mainland China, were re-analyzed to assess the prevalence and distribution of HPV genotypes among Chinese Han women, and to explore the risk of high-grade cervical lesions associated with individual hr-HPV genotypes
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