Ruangsak Ruansukon, MD¹ , Arphamart Nanthiphatthanchai, MD¹ , Chokdee Chulaphark, MD¹

Objective: To determine the prevalence, genotype distribution, and associated histopathologic outcomes of high-risk human papillomavirus (HR-HPV) infection among women undergoing primary cervical cancer screening using self-sampling in Phitsanulok Province.

Materials and Methods: A cross-sectional study was conducted among women aged 15-60 years who participated in a self-sampling HPV screening program between October 2023 and September 2024. Women positive for HPV16/18 or non-16/18 HR-HPV (OHR-HPV) types with abnormal cytology (ASC-US or worse) were referred for colposcopy and further evaluation. Histopathologic findings were classified according to the CIN system.

Results: Of 8,701 eligible participants, 874 tested positive for HR-HPV, yielding a prevalence of 10.1%. The highest prevalence occurred in the 15 to 29-year age group (35.4%). Non-16/18 HR-HPV genotypes were the most common (82.5%), followed by HPV16 (9.0%), HPV18 (2.4%), and multiple infections (6.1%). Histopathologic examination revealed benign lesions in 79.5%, CIN1 in 10.0%, and CIN2+ in 10.5% of HR-HPV-positive women. HPV16 and OHR-HPV combined demonstrated the highest absolute risk for CIN2+, while OHR-HPV also showed significant associations with high-grade lesions.

Conclusion: The prevalence of HR-HPV infection in Phitsanulok was 10.1%, with non-16/18 genotypes predominating. HR-HPV infection was significantly associated with CIN2+ lesions. These provide important epidemiological data to support public health planning, resource allocation, and underscore the value of self-sampling HPV testing as an effective tool for increasing screening coverage and supporting cervical cancer elimination strategies.

Received 25 December 2025 | Revised 2 June 2026 | Accepted 16 June 2026

J Med Assoc Thai 2026;109(9):718-24

DOI: 10.35755/jmedassocthai.2026.9.04048