High-risk human papillomavirus (hr-HPV) prevalence and abnormal cervical cytology in rural high-altitude communities: a population-based cross-sectional study in the Southern Tibetan Plateau, China (2023–2024)
Abstract Background Cervical cancer prevention remains challenging in resource-limited high-altitude regions. This study investigated the prevalence of high-risk human papillomavirus (hr-HPV) and cytological abnormalities in southern Tibet, China. Methods A population-based cross-sectional study (20...
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2025-08-01
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| Online Access: | https://doi.org/10.1186/s12985-025-02909-1 |
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| author | Min Chen Yeshi Lhamo Kelsang Chödrön Le Chen |
| author_facet | Min Chen Yeshi Lhamo Kelsang Chödrön Le Chen |
| author_sort | Min Chen |
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| description | Abstract Background Cervical cancer prevention remains challenging in resource-limited high-altitude regions. This study investigated the prevalence of high-risk human papillomavirus (hr-HPV) and cytological abnormalities in southern Tibet, China. Methods A population-based cross-sectional study (2023–2024) enrolled 21,112 women from the Shannan Region (altitude: 3500–6000 m). The participants underwent hr-HPV genotyping (16/18 and 16 other types) and ThinPrep cytologic testing (TCT). Statistical analyses included χ² tests and quadratic regression. Results The overall hr-HPV prevalence was 9.57% (2,021/21,112). Non-16/18 types predominated (83.37% of infections), with HPV16/18 accounting for 1.59% of infections. Age-stratified analysis revealed a U-shaped infection curve: peaks at 20–24 years (16.07%) and ≥ 65 years (11.84%), nadir at 45–49 years (8.94%; R²=0.89, p < 0.01). Cytological abnormalities occurred in 8.27% (1,746/21,112) of the patients, predominantly ASC-US (79.5%). The ≥ 65 years participants presented the highest abnormality rate (11.84% vs. other groups). Hr-HPV positivity correlated strongly with cytological severity (p < 0.001), increasing from NILM (7.84%) to HSIL (92.31%). HPV16/18 was more prevalent in high-grade lesions (HSIL: 38.46%; OR = 60.2 vs. NILM, 95% CI: 18.4–196.7). Conclusion Shannan has a distinct hr-HPV epidemiology characterized by a lower prevalence, U-shaped age distribution, and non-16/18 type dominance. The resurgence of infections/abnormalities in elderly women warrants age-tailored screening. These findings support prioritizing multivalent vaccines in this high-altitude population. |
| format | Article |
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| institution | Kabale University |
| issn | 1743-422X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
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| series | Virology Journal |
| spelling | doaj-art-e888d9d12c2d4e3b803a8778bbe41bca2025-08-20T03:42:19ZengBMCVirology Journal1743-422X2025-08-012211810.1186/s12985-025-02909-1High-risk human papillomavirus (hr-HPV) prevalence and abnormal cervical cytology in rural high-altitude communities: a population-based cross-sectional study in the Southern Tibetan Plateau, China (2023–2024)Min Chen0Yeshi Lhamo1Kelsang Chödrön2Le Chen3Clinic Center of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWomen’s Health Department, Shannan Maternal and Child Health Hospital, Tibet Autonomous RegionWomen’s Health Department, Shannan Maternal and Child Health Hospital, Tibet Autonomous RegionDepartment of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background Cervical cancer prevention remains challenging in resource-limited high-altitude regions. This study investigated the prevalence of high-risk human papillomavirus (hr-HPV) and cytological abnormalities in southern Tibet, China. Methods A population-based cross-sectional study (2023–2024) enrolled 21,112 women from the Shannan Region (altitude: 3500–6000 m). The participants underwent hr-HPV genotyping (16/18 and 16 other types) and ThinPrep cytologic testing (TCT). Statistical analyses included χ² tests and quadratic regression. Results The overall hr-HPV prevalence was 9.57% (2,021/21,112). Non-16/18 types predominated (83.37% of infections), with HPV16/18 accounting for 1.59% of infections. Age-stratified analysis revealed a U-shaped infection curve: peaks at 20–24 years (16.07%) and ≥ 65 years (11.84%), nadir at 45–49 years (8.94%; R²=0.89, p < 0.01). Cytological abnormalities occurred in 8.27% (1,746/21,112) of the patients, predominantly ASC-US (79.5%). The ≥ 65 years participants presented the highest abnormality rate (11.84% vs. other groups). Hr-HPV positivity correlated strongly with cytological severity (p < 0.001), increasing from NILM (7.84%) to HSIL (92.31%). HPV16/18 was more prevalent in high-grade lesions (HSIL: 38.46%; OR = 60.2 vs. NILM, 95% CI: 18.4–196.7). Conclusion Shannan has a distinct hr-HPV epidemiology characterized by a lower prevalence, U-shaped age distribution, and non-16/18 type dominance. The resurgence of infections/abnormalities in elderly women warrants age-tailored screening. These findings support prioritizing multivalent vaccines in this high-altitude population.https://doi.org/10.1186/s12985-025-02909-1High-risk HPVCervical cancer screeningTibetan plateauAge-specific prevalenceCytological abnormalitiesHigh-altitude health |
| spellingShingle | Min Chen Yeshi Lhamo Kelsang Chödrön Le Chen High-risk human papillomavirus (hr-HPV) prevalence and abnormal cervical cytology in rural high-altitude communities: a population-based cross-sectional study in the Southern Tibetan Plateau, China (2023–2024) Virology Journal High-risk HPV Cervical cancer screening Tibetan plateau Age-specific prevalence Cytological abnormalities High-altitude health |
| title | High-risk human papillomavirus (hr-HPV) prevalence and abnormal cervical cytology in rural high-altitude communities: a population-based cross-sectional study in the Southern Tibetan Plateau, China (2023–2024) |
| title_full | High-risk human papillomavirus (hr-HPV) prevalence and abnormal cervical cytology in rural high-altitude communities: a population-based cross-sectional study in the Southern Tibetan Plateau, China (2023–2024) |
| title_fullStr | High-risk human papillomavirus (hr-HPV) prevalence and abnormal cervical cytology in rural high-altitude communities: a population-based cross-sectional study in the Southern Tibetan Plateau, China (2023–2024) |
| title_full_unstemmed | High-risk human papillomavirus (hr-HPV) prevalence and abnormal cervical cytology in rural high-altitude communities: a population-based cross-sectional study in the Southern Tibetan Plateau, China (2023–2024) |
| title_short | High-risk human papillomavirus (hr-HPV) prevalence and abnormal cervical cytology in rural high-altitude communities: a population-based cross-sectional study in the Southern Tibetan Plateau, China (2023–2024) |
| title_sort | high risk human papillomavirus hr hpv prevalence and abnormal cervical cytology in rural high altitude communities a population based cross sectional study in the southern tibetan plateau china 2023 2024 |
| topic | High-risk HPV Cervical cancer screening Tibetan plateau Age-specific prevalence Cytological abnormalities High-altitude health |
| url | https://doi.org/10.1186/s12985-025-02909-1 |
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