Human papillomavirus prevalence, genotype distribution, risk factors, and cervical pathology association in women aged 50 years and older: a retrospective cross-sectional study in Xinjiang, China

Background: Persistent high-risk human papillomavirus (HPV) infection is the primary cause of cervical cancer, but epidemiological data on HPV in women aged ≥50 years-especially in ethnically diverse, resource-limited regions such as Xinjiang, China-remain insufficient. Older women face underrecognized risks due to age-related immune decline and inadequate screening, highlighting the need for targeted research. Methods: sample size calculation indicated a minimum requirement of 544 participants, which was exceeded. Sociodemographic (age, education), behavioral (sexual activity frequency, smoking and alcohol use), and clinical variables (age at menopause, parity, history of cervical surgery, body mass index [BMI]) were extracted from medical records. HPV status and genotypes were detected using a PCR-based DNA microarray, and cervical pathology was classified according to WHO criteria. Statistical analyses were preceded by assessment of variable normality. Analyses included descriptive statistics, binary and ordinal logistic regression, chi-square tests, t-tests/ANOVA, and point-biserial correlation analysis (SPSS 26.0; p99.9%. Conclusion: Women aged ≥50 years in Xinjiang have a non-negligible HPV prevalence, with HPV16 and HPV53 as dominant genotypes. A history of cervical surgery was associated with a markedly lower likelihood of HPV detection in this cross-sectional analysis. The association between sexual activity frequency and HPV status was not consistent across analyses and requires cautious interpretation. HPV positivity was strongly correlated with cervical pathological lesions, emphasizing the urgency of tailored screening and prevention strategies for this population.