Objective To explore the current status of high-risk human papillomavirus (HR-HPV) infection in women of different ages and the application of the Bethesda system (TBS) cytology combined with DNA quantitative analysis in early cervical carcinoma (CC) screening.

Methods Women (n= 5 800) who underwent HR-HPV examination and CC screening in Fuyang People's Hospital from January 2021 to February 2023 and had biopsy results were selected as the research subjects. Based on the occurrence of HR-HPV infection, they were divided into HR-HPV positive group (n= 1 791) and HR-HPV negative group (n= 4 009). Fluorescence polymerase chain reaction (PCR) was used for HR-HPV detection, and risk factor analysis was conducted based on demographic and epidemiological data. TBS cytology combined with DNA quantitative analysis was conducted, using colposcopy biopsy as the “gold standard” to analyze the clinical significance of the combined examination of the two for cervical lesions. Consistency analysis was conducted using the Kappa test with multi-classified data. Multiple Logistic regression was used to analyze risk factors and construct regression equations. Receiver operating characteristics (ROC) curve was used to evaluate the predictive performance of the model.

Results The infection rate of HR-HPV showed an upward trend with age (P<0.05). The incidence of cervical lesions in HR-HPV infected patients aged ≤60 years old showed increasing trend with age. The infection rates of HPV 16/18 and other 12 types of HR-HPV in patients >60 years old were higher than those in patients ≤60 years old (P<0.05). Multiple Logistic regression analysis showed that age, place of residence, smoking, age of first sexual intercourse, contraceptive methods, sexual partners, and cleaning before and after sexual intercourse were all independent influencing factors for HR-HPV infection (P<0.05). The area under the curve (AUC) of the predictive performance ROC curve of the logistic regression equation was 0.815 (95% confidence interval 0.753~0.892), indicating high prediction accuracy. There were significant differences in the sensitivity, specificity, and accuracy of TBS cytology, DNA quantitative analysis, and their combined examination (all P<0.05); The consistency analysis results showed that the Kappa values of the three inspection methods were 0.240, 0.338, and 0.549, respectively.

Conclusions The infection rate of HR-HPV and the incidence of cervical lesions in ≤60 years old HR-HPV infected patients both show increasing trend with age. The infection rates of HPV 16/18 and other 12 types of HR-HPV are higher in >60 years old patients. Age, place of residence, smoking, age of first sexual intercourse, contraceptive method, sexual partner, and cleaning before and after sexual intercourse are all independent influencing factors of HR-HPV infection. The combination of TBS cytology and DNA quantitative analysis can improve the sensitivity and specificity of diagnosis and increase the accuracy of clinical screening for cervical lesions.