Overall and type-specific HPV prevalence

A total of 164,137 women were involved in the present study, including 118,484 females in the OG and 45,653 females in the HFG (Table 1). The overall prevalence of HPV was 17.35%, with 28,480 out of the total 164,137 cases being positive for HPV among women. The positive cases accounted for 19.10% (22,626/118,484) of the OG and 12.82% (5854/45,653) of the HFG, respectively. The prevalence of HPV in the OG was significantly higher than that of the HFG (P < 0.01).

Table 1 HPV genotype distribution in the total population, the OG, and the HPG

A total of 27 HPV genotypes were identified in the present study. The total number of positive HPV genotypes was 37,106, among which 29,703 were from the OG, with a per capita carrying rate of 0.25 (29,703/118,484). A total of 7403 positive HPV genotypes were noted in the HFG, with a per capita carrying rate of 0.16 (7403/45,653).

In total, HPV 52 (3.29%), 58 (1.96%), 53 (1.87%), 16 (1.67%), and 61 (1.34%) were the five most prevalent HPV genotypes. The five most common genotypes were HPV 52, 58, 16, 53, and 61 in the OG, and the five most common genotypes were HPV 52, 53, 58, 61, and 81 in the HFG (Fig. 1). The percentage of positive detection for each HPV type was analyzed over a total period of 5 years (Fig. 2). The six most common genotypes, namely HPV 52 (14.54%), 58 (8.68%), 53 (8.27%), 16 (7.40%), 61 (5.94%), and 81 (5.76%), accounted for approximately 50% of all infection types (Additional file 1: Fig. S1).

Fig. 1

The prevalence of HPV genotypes ranked from highest to lowest. The abscissa was sorted by HPV prevalence in total from high to low. HPV Human papillomavirus

Fig. 2

Comparison of the number of multiple infections and single infections

Genotype-specific prevalence of HR-HPV

HR-HPV was detected in 26,568 individuals, with a total infection rate of 16.19% (26,568/164,137) (Table 1). The HR-HPV infection rate of the OG and the HFG was 18.08% (21,424/118,484) and 11.27% (5144/45,653), respectively. The HR-HPV infection rate of the OG was significantly higher than that of the HFG (P < 0.01).

The most prevalent HR-HPV genotypes were HPV 52 (3.29%, 5397/164,137), followed by HPV 58 (1.96%, 3220/164,137), HPV 53 (1.87%, 3070/164,137), HPV 16 (1.67%, 2746/164,137), and HPV 39 (1.19%, 1947/164,137).

Distribution characteristics of single and multiple HPV infections

The frequency and number of HPV infections are shown in Table 2. Among women with a single HPV infection, HR-HPV infection accounted for 74.33% (12,867/17,286) in the OG and for 70.33% (3273/4,654) in the HFG (P > 0.01). Among women with multiple HPV infections, the multiple infections with the HR-HPV rate accounted for 93.39% (4987/5340) of the population in the OG and for 92% (1104/1200) of the population in the HFG (P > 0.01).

Table 2 Frequency and prevalence of single and multiple HPV infection. HPV, human papillomavirus

Multiple and single HPV genotypes accounted for 40.87% (15,166/37,106) and 59.13% (21,940/37,106) of all positive types, respectively. Single infections and multiple infections were identified across all genotypes (Fig. 2). The prevalence of HPV 16, 39, 52, and 58 in the single infection group was higher than that of the multiple infection group (P < 0.01).

Time trends of prevalence and genotype of HPV

The prevalence of HPV in the OG and HFG indicated almost the same trend (Fig. 3A). The total prevalence of HPV indicated a significant decrease from 23.35% in 2015 to 13.71% in 2017. Subsequently, the prevalence slowly increased to 18.35% in 2020. The number of HPV genotyping tests increased every year during the period 2015–2019. However, the COVID-19 lockdown in 2020 resulted in a reduction in the quantity of HPV testing (Fig. 3B).

Fig. 3

Summary of HPV testing volume and infection rate from 2015 to 2020. A Trend of HPV infection in each group. B The number of HPV genotyping tests during the period 2015–2020. HPV Human papillomavirus

The majority of viral infection types were consistent with the overall trend of HPV-positive infections; however, certain genotypes demonstrated an annual fluctuation in prevalence (Fig. 4).

Fig. 4

Time trends of specific genotypes of HPV. A HPV 16, 18, and 33 indicated a downward trend. B HPV 52, 53, 59 and 61 indicated an upward trend. HPV, human papillomavirus

Age-specific prevalence and genotype of HPV

All the participants were stratified into 8 groups based on their age (Table 3). The overall age-specific prevalence of HPV exhibited bimodal distribution, with two distinct peaks observed. The infection rates for the specific age groups were as follows: 44.65%, 19.79%, 15.14%, 15.90%, 19.76%, 27.35%, 23.04%, and 15.87% (Fig. 5). The first peak corresponded to 44.65% in the 10–19 age group. The prevalence of HPV decreased to 19.79% in the 20–29 age group and continuously increased to 27.35% in the 60–69 age group. The lowest prevalence (below 16%) was observed in the age group of 30–49, with a predominant representation of participants within this specific age range. Two infection peaks corresponding to subjects under 20 and between 60 and 69 years of age were noted in the OG, whereas only one infection peak was identified in the HFG among individuals aged 60–79.

Table 3 Summary of HPV infection in the OG and HPG at each age groupFig. 5

The overall age-specific prevalence of HPV. HPV, human papillomavirus

The age-specific percentage of the HPV genotype in the positive cases was analyzed (Additional file 1: Table S1). The data indicated that young subjects under the age of 20 infected with HPV 6, 11, 16, 18, and 52 were the main subjects infected, accounting for approximately half of the total infection cases. The infection rates of HPV 6 and 11 were significantly higher in the aforementioned age group (< 20 years of age) than those of the other age groups, while HPV 53 infected a significantly lower number of subjects in the < 20-year group compared with that of the other age groups.

The overall risk of the six most common HR-HPV genotypes (HPV 52, 58, 53, 16, 39, and 18) exhibited an age-dependent increase. However, individual genotypes displayed distinct age-related trends (Fig. 6).

Fig. 6

Age-specific prevalence of the six most common HR-HPV genotypes. A The overall prevalence of HPV 52, 58, 53, 16, 39, and 18 was gradually increased with age. B HPV 52 indicated an apparent bimodal pattern, while HPV 18 hardly changed with age. HPV 53 and 58 increased with age, while HPV 16 decreased with age until 70. HR-HPV High-risk HPV, HPV Human papillomavirus