Data Sheet 1_From HPV genotypes to cervical lesion burden: public health-relevant heterogeneity across 1.29 million screening records in Guangdong, China.pdf

Sensitivity analyses retained only the earliest eligible record for each identifiable woman.</p>Results<p>High-risk HPV was detected in 63,004 records (4.88%). Low-grade squamous intraepithelial lesions (LSIL), high-grade/microinvasive cervical lesions, and cervical cancer were recorded in 11,106 (0.86%), 6,633 (0.51%), and 382 (0.03%) records, respectively. The cities with the highest pooled proportions differed across lesion categories.

Overall low-risk and high-risk HPV positivity showed significant positive annual percentage changes of 19.21 and 8.05%, respectively, whereas no individual high-risk genotype changed significantly. High-risk HPV positivity was highest in Northern Guangdong (5.6%), and HPV16 was the most frequently reported genotype in all four regions. Compared with participants aged <45 years, those aged ≥65 years had adjusted relative risks of 1.52 (95% CI, 1.22–1.91) for high-grade/microinvasive cervical lesions, 5.02 (2.43–10.35) for cervical cancer, and 1.51 (1.39–1.63) for high-risk HPV positivity.

Age-related differences in severe lesions were more evident among records with no prior screening reported. The detection proportion of HPV16 increased from 28.6% in LSIL to 50.0% in high-grade/microinvasive cervical lesions and 69.3% in cervical cancer. HPV18 ranked second in cancer (18.3%), whereas HPV52 and HPV58 were more frequent in LSIL and high-grade/microinvasive lesions.</p>Conclusion<p>This province-wide screening study linked reported HPV genotype patterns with cervical lesion burden and identified uneven disease burden across Guangdong, a higher burden of severe cervical lesions among older participants with no prior screening reported, and distinct genotype-specific detection patterns across lesion grades.

These findings support locally adapted screening and follow-up strategies that prioritize high-burden regions, under-screened older women, and genotype-informed follow-up of HPV-positive women.</p>