Epidemiological study of HPV infection in Shanghai: a population study based on screening for HPV infection

Human papillomavirus (HPV) infection is the primary cause of cervical cancer (CC). Although the HPV vaccination rate has been increasing, the HPV infection rate remains persistently high. Therefore, understanding the epidemiological patterns of HPV is crucial for controlling its infection and transmission. To investigate the HPV epidemiological characteristics and its association with cervical epithelial abnormalities, 21,188 individuals who underwent HPV testing between September 2023 and September 2025 were enrolled. The overall HPV positivity rate was 55.09%, with a higher infection rate in females than in males, and the infection rate increased with age. HPV infections often occurred in the form of mixed infections, which accounted for 50.91% of all positive samples, mainly involving 2 to 3 subtypes. Among the top five most prevalent HPV subtypes, HPV06 and HPV31, both low-risk genotypes, were the most common single infection types and also the most frequently involved in mixed infections. HPV31, HPV45, and HPV16 were the most common high-risk subtypes, and their infections tended to present as mixed infections. HPV infection and mixed infection rates were positively correlated with lesion severity: 94.12% (68.75% mixed) in ASC-H, 90.63% (58.62% mixed) in LSIL, 77.55% (55.26% mixed) in ASC-US, and 65.20% (37.07% mixed) in NILM. HPV16/18 exhibited a strong association with high-grade lesions. These results confirm age- and gender-specific HPV distribution patterns, emphasizing the role of high-risk subtypes and mixed infections in lesion progression, and support the need for tailored screening, vaccination, and risk-stratified management.