Analysis of epidemiological characteristics of vaginal microecology, ThinPrep cytology, and human papillomavirus infection in women in Western China.

BACKGROUND

With the rollout of HPV vaccination in China from 2018, the epidemiological distribution of female HPV infections has changed. We aimed to characterize the vaginal microecology (VME), ThinPrep cytologic test (TCT) results, and HPV infection epidemiology among women in Western China and to analyze their correlations to inform cervical cancer screening.

METHODS

We retrospectively analyzed VME, TCT, and HPV results for all women who underwent voluntary screening for gynecological diseases at Chongqing Cancer Hospital in 2023 to assess epidemiological characteristics and correlations among VME, TCT, and HPV infection. VME and TCT results were available for a subset of 1,718 participants who completed all three tests, allowing correlation analyses.

RESULTS

Among 8,528 patients, 9.53% were HPV positive. The three most common HPV types were 52, 58, and 16; HPV 18 fell from the previous top three to 10th. Multiple HPV infections occurred in 1.31% of patients, most frequently involving types 52, 58, and 51.The HPV infection rate in the 40-49 year-old group (8.07%) was the fifth highest across all age groups, differing markedly from previous studies. In total, 1,718 participants completed VME, TCT, and HPV testing, in which the HPV-positive cases accounted for 6.11%. Patients with bacterial vaginosis and dysbiosis had significantly higher HPV infection rates (P = 0.016 and P = 0.01, respectively) than those with normal flora, whereas patients with vulvovaginal candidiasis (VVC) had significantly lower rates (P = 0.044). Abnormal TCT rates showed a similar pattern: significantly higher in bacterial vaginosis (P = 0.012) and significantly lower in VVC (P = 0.029).

CONCLUSIONS

The distribution of HPV types and age groups in Western China differs from previous reports. This may be attributable to HPV vaccination and may reflect selection bias related to reduced reproductive health attention among postmenopausal women. VME is differentially associated with cervical HPV infection and TCT findings. The correlation among VME, TCT, and HPV infection warrants further investigation.

TRIAL REGISTRATION: Not applicable.