Spatial Distribution Analysis of High-Risk Human Papillomavirus (hrHPV) Infection Rates in Guizhou Province, 2023 - 2024: A Population-Based Study of 1.35 Million Individuals

Background: The present study aimed to analyze the spatial distribution characteristics of high-risk human papillomavirus (hrHPV) infection prevalence among cervical cancer screening participants aged 35 - 64 in Guizhou province, providing evidence for optimizing cervical cancer screening and prevention strategies. Methods: A total of 1,355,148 cases from free cervical cancer screenings conducted between 2023 and 2024 were included. ArcGIS 10.2 was utilized to map the geographical distribution of hrHPV infection rates. Global and local spatial autocorrelation analyses were performed, followed by space-time scan analysis using SatScan 9.1. Results: The hrHPV positivity rate was 13.10% (177,466/1,355,148). Spatial autocorrelation was observed in 2023 (Moran’s I = 0.334, P < 0.05), while no significant clustering was detected in 2024 (Moran’s I = 0.080, P > 0.05). The high-value-high-value aggregation area in 2023 included 2 counties under the jurisdiction of Qianxinan prefecture, 1 county under the jurisdiction of Qiandongnan prefecture, and 2 counties under the jurisdiction of Qiannan prefecture; the high-value-high-value aggregation area in 2024 included 2 counties under the jurisdiction of Qianxinan prefecture. Space-time scan analysis revealed three significant clusters (covering 29 counties) during 2023 - 2024: (1) A primary cluster in south-central Guizhou (11 counties, 2023); (2) a secondary cluster in central Guizhou (6 counties, 2024); and (3) a tertiary cluster in northeastern Guizhou (12 counties, 2023). Conclusions: During 2023 - 2024, the overall infection rate of hrHPV in Guizhou province exhibited an upward trend, with significant spatiotemporal clustering. Consequently, areas identified as potential clusters, particularly certain districts and counties within Qiandongnan autonomous prefecture, Qianxinan Buyei and Miao autonomous prefecture, and Qiannan Buyei and Miao autonomous prefecture, warrant heightened attention. These areas should adjust and optimize regional prevention and control strategies for cervical cancer screening programs based on the spatial distribution characteristics of the epidemic.