ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gynecological Oncology
Human Papillomavirus (HPV) Prevalence, Genotype Distribution, Risk Factors, and Cervical Pathology Association in Women Aged 50 Years and Older: A Retrospective Cross-Sectional Study in Xinjiang, China
Provisionally accepted
- 1Department of Gynecology, People's Hospital of Kuqa, Kuqa, China
- 2Ningbo Women and Children's Hospital, Ningbo, China
- 3Burn Department, Ningbo No.2 Hospital, Ningbo, China
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Background: Persistent high-risk human papillomavirus (HPV) infection is the primary cause of cervical cancer, but epidemiological data on HPV in women aged ≥50 years—especially in ethnically diverse, resource-limited regions like Xinjiang, China— remain insufficient. Methods: A retrospective cross-sectional study was conducted on 640 women aged ≥50 years who underwent cervical HPV testing at a tertiary hospital in Kuqa, Xinjiang, from January 2024 to March 2025. A priori sample size calculation indicated a minimum requirement of 544 participants, which was exceeded. Sociodemographic (age, education), behavioral (sexual activity frequency, smoking/alcohol use), and clinical variables (menopausal age, parity, cervical surgery history, BMI) were extracted from medical records. HPV status and genotypes were detected via PCR-based DNA microarray, and cervical pathology was classified per WHO criteria. Statistical analyses were preceded by assessment of variable normality. Analyses included descriptive statistics, binary and ordinal logistic regression, chi-square tests, t-tests/ANOVA, and point-biserial correlation analysis. Results: The overall HPV prevalence was 20.6% (132/640), with high-risk genotypes HPV16 (29.5%), HPV53 (18.2%), and HPV58 (12.1%) being the most prevalent. Binary logistic regression showed that a history of cervical surgery was strongly associated with a reduced likelihood of HPV positivity (OR=0.015, 95% CI: 0.008--0.028, p<0.001). Univariate analysis indicated that sexual activity frequency was higher in HPV-positive than HPV-negative women (2.35±1.14 vs. 2.11±1.10, t=2.225, p=0.026), but this association was not significant in the multivariate model (OR=1.020, 95% CI: 0.796--1.307, p=0.874). Point-biserial correlation analysis revealed a negative association between HPV positivity and BMI. HPV-positive women had a higher rate of cervical intraepithelial neoplasia (CIN) and squamous cell carcinoma (SCC) (31.1% vs. 1.2% in HPV-negative women, p<0.001). A post-hoc power analysis for the cervical surgery-HPV association yielded a power >99.9%. Conclusion: Women aged ≥50 years in Xinjiang have a non-negligible HPV prevalence, with HPV16/53 as dominant genotypes. A history of cervical surgery was associated with a markedly lower likelihood of HPV detection in this cross-sectional analysis. The association between sexual activity frequency and HPV status was not consistent across analyses and requires cautious interpretation. HPV positivity strongly correlates with cervical pathological lesions, emphasizing the urgency of tailored screening and prevention strategies for this population.
Keywords: cervical pathology, Genotype distribution, HPV infection, Older women, Risk factors, Xinjiang region
Received: 29 Aug 2025; Accepted: 18 Dec 2025.
Copyright: © 2025 Li, He, Zhang, Turson, Lou and Cheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Li He
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