Journal of Nursing

HPV Testing Can Be Used as a Primary Screening Method for Cervical Lesions Among Women in Western China

Xiaoge Li, Yutong Wu, Jin Wu, Sijing Li, Ying Jia


Objective: The purpose of our study is to explore screening strategies suitable for cervical cancer and precancerous lesions in Western Chinese women. Methods: Between January 2010 and December 2020, a total of 7009 patients were diagnosed with high-grade squamous intraepithelial neoplasia (CIN2+) after HPV testing, cytology screening or a combination of both. Results: The positive rate of human papillomavirus (HPV) was 91.2% and the cytology was 75.1%. The negative rate of co-testing was 2%. 2453 (45.2%) cases were infection with HPV16, following HPV58 (1131, 20.8%), HPV52 (1043, 19.2%), HPV33 (566, 10.4%), HPV18 (294, 5.4%). HPV16/18-positive and cytology-negative infection rate was 54.5%, HPV52/58/33-positive and cytology-negative infection rate was 44.7%, the difference was 9.8%. 35-45 years old is the peak age for the incidence of CIN2+ patients. Conclusion: The common genotypes of HPV infection are HPV16, 58, 52, 33 and 18. Cytology negative patients with HPV52/58/33 positive are recommended to be referred for colposcopy as soon as possible. HPV testing is the primary method of cervical cancer or cervical lesions screening among women in western China, and HPV testing is more sensitive than cytology in predicting cervical lesions.


Cervical Cancer; High-Grade Squamous Intraepithelial Lesions; Cervical Cancer Screening; HPV; Cytology

Full Text:


Included Database


WHO. Global strategy towards the elimination of cervical cancer as a public health problem. WHO 2019.

Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, et al. Cancer Statistics in China, 2015. CA. Cancer J. Clin. 2016, 66 (2), 115–132.

Papanicolaou GN, Trauat HF. The diagnostic value of vaginal smears in carcinoma of the uterus. American Journal of Obstetrics and Gynecology 1941; 42: 193–206.

Zhao XL, Hu SY, Zhang Q, Dong L, Feng RM, Han R, et al. High-Risk Human Papillomavirus Genotype Distribution and Attribution to Cervical Cancer and Precancerous Lesions in a Rural Chinese Population. J. Gynecol. Oncol. 2017, 28 (4), e30.

Yuanyue L, Baloch Z, Yasmeen N, Tao Y, Xiaomei W, Xueshan X. The Distribution of Human Papillomavirus Genotypes in Cervical Cancer and Intraepithelial Neoplasia Lesions among Chinese Women in Yunnan Province. J. Infect. Public Health 2018, 11 (1), 105–110.

Polman NJ, Ebisch RMF, Heideman DAM, Melchers WJG, Bekkers RLM, Molijn A C, et al. Performance of Human Papillomavirus Testing on Self-Collected versus Clinician-Collected Samples for the Detection of Cervical Intraepithelial Neoplasia of Grade 2 or Worse: A Randomised, Paired Screen-Positive, Non-Inferiority Trial. Lancet Oncol. 2019, 20 (2), 229–238.

Arbyn M, Verdoodt F, Snijders PJF, Verhoef VMJ, Suonio E, Dillner L, et al. Accuracy of Human Papillomavirus Testing on Self-Collected versus Clinician- Collected Samples: A Meta-Analysis. Lancet Oncol. 2014, 15 (2), 172–183.

Polman NJ, Snijders PJF, Kenter GG, Berkhof J, Meijer CJLM. HPV-Based Cervical Screening: Rationale, Expectations and Future Perspectives of the New Dutch Screening Programme. Prev. Med. 2019, 119, 108–117.

Huh WK, Ault KA, Chelmow D, Davey DD, Goulart RA, Garcia FAR, et al. Use of Primary High-Risk Human Papillomavirus Testing for Cervical Cancer Screening: Interim Clinical Guidance. Gynecol. Oncol. 2015, 136 (2), 178–182.

Castanon A, Landy R, Sasieni P. By How Much Could Screening by Primary Human Papillomavirus Testing Reduce Cervical Cancer Incidence in England? J. Med. Screen. 2017, 24 (2), 110–112.

Hillemanns P. The Paradigm Shift in Cervical Cancer Screening in Germany. Arch. Gynecol. Obstet. 2016, 293 (1), 3–4.

Schiffman M, Doorbar J, Wentzensen N, de Sanjosé S, Fakhry C, Monk BJ, et al. Carcinogenic Human Papillomavirus Infection. Nat. Rev. Dis. Primer 2016, 2, 16086.

Monsonego J, Cox JT, Behrens C, Sandri M, Franco EL, Yap PS, et al. Prevalence of High-Risk Human Papilloma Virus Genotypes and Associated Risk of Cervical Precancerous Lesions in a Large U.S. Screening Population: Data from the ATHENA Trial. Gynecol. Oncol. 2015, 137 (1), 47–54.

Gage JC, Katki HA, Schiffman M, Fetterman B, Poitras NE, Lorey T, et al. Age-Stratified 5-Year Risks of Cervical Precancer among Women with Enrollment and Newly Detected HPV Infection. Int. J. Cancer 2015, 136 (7), 1665–1671.



  • There are currently no refbacks.

Copyright (c) 2023 Xiaoge Li

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.