Abstract
BACKGROUND: Human papillomavirus (HPV) has been identified as a causative agent of cervical cancer. The aim of this study was to investigate temporal changes in prevalence and geographical distribution of human papillomavirus (HPV) infection in mainland China. METHODS: This study was a systematic review and aggregate data analysis. The literature was searched from multiple databases. The included studies were divided into two groups, the 2010-2016 group and the 2017-2021 group, according to the time period of specimen collection. A total of 17 HPV types were selected. Temporal changes in prevalence and geographical distribution of HPV infection and the effect of the HPV vaccine were analyzed. RESULTS: A total of 1,073,296 females from mainland China were included. The total prevalence of the 17 selected HPV types in 2017-2021 was 26.06% which was significantly higher than the 23.20% in 2010-2016 (P < 0.001). The total prevalence of the 17 selected HPV types significantly increased in 11 regions, among which Jiangxi, Beijing, Chongqing, Inner Mongolia, and Zhejiang increased by more than 1.5 times in 2017-2021 compared to 2010-2016 (P < 0.05). The national prevalence of HPV51, 59, 53, 56, 39, 45, 66, 52, 35, 68 and 58 significantly increased (P < 0.001), while the prevalence of HPV33, 16, 6, and 11 significantly decreased (P < 0.05) in 2017-2021 compared to 2010-2016. The national prevalence of HPV 52, 16, 58, 53, and 51 ranked in the top 5 from 2017-2021. A 10.05% reduction in the national prevalence of 2-HPV type targeted by bivalent vaccine and a 13.09% reduction in that of 4-HPV type targeted by quadrivalent vaccine were found from 2010-2016 through 2017-2021. CONCLUSIONS: The prevalence of HPV infection among females remains high and shows a significant increase in the mainland China. The top five most common HPV types in females in 2017-2021 were HPV 52, 16, 58, 53 and 51. Although some effectiveness of HPV vaccination has already been observed, particular attention should be paid to the high prevalence of nonvaccine genotypes including HPV 53 and HPV 51 in mainland China.