A prospective study of age trends of high-risk human papillomavirus infection in rural China

Le Ni Kang, Philip E. Castle, Fang Hui Zhao, Jose Jeronimo, Feng Chen, Pooja Bansil, Jing Li, Wen Chen, Xun Zhang, You Lin Qiao

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Background: In China, high-risk human papillomavirus (HR-HPV) prevalence is unexpectedly high in older women, but the possible reasons have not been well studied yet. This study investigated the age trends of HR-HPV infection in a prospective study.Methods: A total of 7397 women aged 25-65 years without cervical precancer or cancer were evaluated during 2010-2011 with a stratified sample of 2791 women re-evaluated after one year. Test results for careHPV and careHPV16/18/45 were used to describe the HR-HPV prevalence, incidence and clearance. Risk factors associated with HR-HPV infections were explored using a logistic regression model.Results: The overall HR-HPV prevalence was 13.1% at baseline, with a peak of 19.3% in women aged 55-59 years. The prevalence of HR-HPV (p for trends < 0.001), HPV16/18/45 (p for trends = 0.002), and HR-HPV other than HPV16/18/45 (p for trends = 0.002) generally increased with increasing age. Number of infections that cleared was generally greater than number of incident infections within age groups. One-year clearance rate decreased with increasing age (p for trends < 0.001), however, incidence rate was unrelated to age (p for trends = 0.159). Risk factors that associated with HR-HPV infection differed between younger and older women.Conclusions: The greater HR-HPV prevalence in older versus younger women in rural China may be explained by a cohort effect, higher than expected incidence, and/or poorer clearance at older age.

Original languageEnglish (US)
Article number96
JournalBMC Infectious Diseases
Issue number1
StatePublished - Feb 21 2014
Externally publishedYes


  • Age
  • Cohort effect
  • Human papillomavirus
  • Infection
  • Risk factor

ASJC Scopus subject areas

  • Infectious Diseases


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