The prevalence and role of human papillomavirus genotypes in primary cervical screening in the northeast of China

Background: Studies have shown that type-specific persistence of high-risk human papillomavirus (HPV) infection contributed significantly to cervical carcinogenesis. Methods: In this population-based study (on 24041 women), we report on the prevalent genotypes of HPVs and the prevalent genotypes of HPV persistent infection in the northeast of China. Results: Our results showed that in HPV infected women (45.6% in total), (95% CI, 44.97%-46.23%), 17.35% (95% CI, 16.87%-17.83%) suffered persistent infection. The most common high-risk HPV types in persistent positivity were HPV-16 (18.21%; 95% CI, 17.04%-19.38%), HPV-58 (13.2%; 95% CI, 12.17%-14.23%), HPV-18 (8.66%; 95% CI, 7.81%-9.51%), HPV-52 (7.06%; 95% CI, 6.28%-7.84%) and HPV-33 (6.78%; 95% CI, 6.02%-7.54%). The prevalence of persistent infections with HPV-16,-58, -18, -52 and 33 in cervicitis were lower compared to those in CIN (all P<0.05). HPV-58, -33 and multiple HPV persistent positivity were significantly associated with older age (all P<0.05). HPV-18 persistent positivity was significantly associated with adenocarcinoma and lymphatic metastasis (all P<0.05). HPV-18 persistent positivity was associated with cervical cancer prognosis (P<0.0001). Multivariate analyses showed that HPV-18 persistent positivity, (RR=1.704, 95% CI=1.095-2.654, p=0.028) and lymphatic metastasis (RR=2.304, 95% CI=1.354-3.254, P=0.015) were independent predictors for 3-year survival in cervical cancer. Conclusions: we provided extensive results of HPV genotype prevalence and distribution in the northeast of China. HPV genotyping is worthwhile to perform because of its independent prognostic value in cervical cancer