Nationwide prevalence of high-risk human papillomavirus and cervical cytology findings in Chile: a registry-based study (2019–2024)

Cervical cancer, primarily caused by high-risk human papillomavirus (HR-HPV), remains one of the leading causes of cancer-related death in women globally. No nationwide analysis has integrated molecular HPV testing and cervical cytology using registry-based data. The aim of the present study was to provide the first nationwide registry-based estimate of HR-HPV positivity and age-specific cervical cytological abnormalities within the Chilean National Cervical Cancer Screening Program. A retrospective descriptive analysis was conducted using nationwide aggregate data from the Chilean Ministry of Health (MINSAL), covering the nationwide cervical cancer screening network. A total of 506 712 cervical samples tested for HR-HPV (2020–2024) and 4 055 738 adequate Papanicolaou (PAP) tests (2019–2024) were analyzed. The HR-HPV positivity between 2020 and 2024 was 13.02% (95% confidence interval: 12.93–13.11%), with annual values of 12.34, 12.73, 13.27, 13.47, and 12.85% in 2020, 2021, 2022, 2023, and 2024, respectively. The highest HPV prevalence was observed in G1 (30–44 years), ranging from 15.39 to 16.26%, compared with 8.95–10.55% in G2 (45–64 years) and 5.46–13.30% in G3 (≥65 years). Among all HPV-positive women, HPV-16 accounted for 19.57% of infections, HPV-18 for 6.39%, and pooled HR-HPV types for 74.03%. Regarding PAP results, 95.63% of adequate tests were classified as negative for intraepithelial lesion or malignancy, while low-grade squamous intraepithelial lesion (LSIL) (NIE I) was found in 0.77%, high-grade squamous intraepithelial lesion (HSIL) (NIE II) in 0.33%, and severe HSIL (NIE III) in 0.26% of cases. This nationwide registry-based study establishes the first comprehensive baseline of HR-HPV positivity and cervical cytology in Chile. The predominance of non-16/18 h-HPV infections reinforces the importance of broad-spectrum extended HPV genotyping surveillance and provides a benchmark for evaluating the long-term impact of HPV vaccination and implementation of primary HPV screening.