Background: Human papillomavirus (HPV) infection is a major cause of cervical cancer and other genital diseases. Regional epidemiological data on HPV prevalence and genotype distribution are crucial for informing local prevention and screening strategies. This study aimed to characterize the prevalence and genotype-specific distribution patterns of HPV among women in Tongliao, Inner Mongolia.

Objectives: This study aimed to characterize the prevalence and genotype-specific distribution patterns of HPV infection among women attending a tertiary hospital in Tongliao, Inner Mongolia, between 2020 and 2024. By evaluating overall infection rates and age-specific profiles, the study sought to identify distinct peak patterns, particularly late-age rebounds, through post-hoc statistical analysis. These findings are intended to provide localized epidemiological evidence to support the development of age-tailored screening and targeted vaccination strategies in the region.
 
Methods: A retrospective analysis was conducted on 50,769 women visiting the obstetrics and gynecology department of a tertiary hospital in Tongliao between 2020 and 2024. Statistical analysis was performed to calculate overall prevalence, distribution of single and multiple infections, and age-specific HPV infection patterns using the chi-square test. For genotypes showing significant age-related differences, post-hoc pairwise comparisons with Bonferroni correction were employed to identify specific peak patterns.
 
Results: The overall HPV prevalence was 20.65% (10,488/50,769). HPV-52 was the most prevalent single genotype (17.37% of infections), followed by HPV16 and HPV 58. Single-type infections accounted for 66.82% of positive cases, while multiple-type infections constituted 33.18%. Age-stratified analysis of 16 common genotypes revealed distinct distribution patterns (P < 0.05). While certain genotypes primarily exhibited a peak in women aged <30 years, a significant U-shaped distribution was identified for several other genotypes. Post-hoc pairwise comparisons confirmed that for these specific types, prevalence significantly rebounded in the >45 age group after reaching a nadir in the 30-45 group (P < 0.05), highlighting a distinct late-age infection profile.
 
Conclusions: This five-year study indicates a significant burden of HPV infection among appointed women patients in Tongliao, with age-specific profiles varying significantly by genotype. The identification of a statistically significant second peak in prevalence among women aged >45 highlights the importance of age-tailored prevention and targeted vaccination strategies. Screening programs should emphasize continuous monitoring for peri-menopausal and older women to address the risk of late-age infection rebound

HPV genotype prevalence stratified by age groups (<30, 30–45, and >45 years)