{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T04:07:26Z","timestamp":1792382846986,"version":"4.4.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-34501-6","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T12:36:40Z","timestamp":1767789400000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Age distribution of high-risk HPV infection and cervical lesions in an unvaccinated adult Brazilian population within an organized screening program"],"prefix":"10.1038","volume":"16","author":[{"given":"Rafaella Moraes","family":"Rego","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diama Bhadra","family":"Vale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cirbia Silva","family":"Campos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leandro","family":"Vasconcelos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Campos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena Cunha Lopes","family":"Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle Garcia","family":"Discacciati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Carlos","family":"Zeferino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio Cesar","family":"Teixeira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"34501_CR1","doi-asserted-by":"crossref","unstructured":"Tewari, K. S. Cervical cancer NEJM 392, 56\u201371 (2025).","DOI":"10.1056\/NEJMra2404457"},{"key":"34501_CR2","first-page":"322","volume":"5","author":"J Wu","year":"2025","unstructured":"Wu, J. et al. Global burden of cervical cancer: current estimates, Temporal trend and future projections based on the GLOBOCAN 2022. J. Natl. Cancer Cent. 5, 322\u2013329 (2025).","journal-title":"J. Natl. Cancer Cent."},{"key":"34501_CR3","unstructured":"Ferlay, J. et al. Global Cancer Observatory: Cancer Today (International Agency for Research on Cancer, 2024). https:\/\/gco.iarc.who.int\/today"},{"key":"34501_CR4","unstructured":"National Cancer Institute. Cancer incidence in Brazil. Estimate (2023). https:\/\/www.inca.gov.br\/sites\/ufu.sti.inca.local\/files\/\/media\/document\/\/estimativa-2023.pdf (2023)."},{"key":"34501_CR5","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1158\/1055-9965.EPI-12-1406","volume":"22","author":"M Schiffman","year":"2013","unstructured":"Schiffman, M. & Wentzensen, N. Human papillomavirus infection and the multistage carcinogenesis of cervical cancer. Cancer Epidemiol. Biomarkers Prev. 22, 553\u2013560 (2013).","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"34501_CR6","doi-asserted-by":"publisher","first-page":"1933","DOI":"10.1038\/s41416-023-02227-9","volume":"128","author":"C Gilham","year":"2023","unstructured":"Gilham, C., Sargent, A., Crosbie, E. J. & Peto, J. Long-term risks of invasive cervical cancer following HPV infection: follow-up of two screening cohorts in Manchester. Br. J. Cancer. 128, 1933\u20131940 (2023).","journal-title":"Br. J. Cancer"},{"key":"34501_CR7","unstructured":"World Health Organization. Human papillomavirus vaccines: WHO position paper. Weekly Epidemiological Record 50, 645\u2013672. December (2022). https:\/\/iris.who.int\/bitstream\/handle\/10665\/365350\/WER9750-eng-fre.pdf?sequence=1 (2022)."},{"key":"34501_CR8","unstructured":"World Health Organization editor. WHO Guidelines for Screening and Treatment of Precancerous Lesions for Cervical Cancer Prevention (World Health Organization, 2013)."},{"key":"34501_CR9","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1016\/S0140-6736(05)67069-9","volume":"366","author":"GM Clifford","year":"2005","unstructured":"Clifford, G. M. et al. Worldwide distribution of human papillomavirus types in cytologically normal women in the international agency for research on cancer HPV prevalence surveys: a pooled analysis. Lancet 366, 991\u2013998 (2005).","journal-title":"Lancet"},{"key":"34501_CR10","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1038\/s41416-020-0920-9","volume":"123","author":"M Kyrgiou","year":"2020","unstructured":"Kyrgiou, M. et al. Cervical screening: ESGO-EFC position paper of the European society of gynaecologic oncology (ESGO) and the European federation of colposcopy (EFC). Br. J. Cancer. 123, 510\u2013517 (2020).","journal-title":"Br. J. Cancer"},{"key":"34501_CR11","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1055\/s-0041-1739314","volume":"44","author":"CF Carvalho","year":"2022","unstructured":"Carvalho, C. F. et al. Cervical cancer screening with HPV testing: updates on the recommendation. Rev. Bras. Ginecol. Obstet. 44, 264\u2013271 (2022).","journal-title":"Rev. Bras. Ginecol. Obstet."},{"key":"34501_CR12","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1086\/657321","volume":"202","author":"L Bruni","year":"2010","unstructured":"Bruni, L. et al. Cervical human papillomavirus prevalence in 5 continents: Meta-Analysis of 1 million women with normal cytological findings. J. Infect. Dis. 202, 1789\u20131799 (2010).","journal-title":"J. Infect. Dis."},{"key":"34501_CR13","doi-asserted-by":"publisher","first-page":"6734","DOI":"10.1016\/j.vaccine.2023.10.002","volume":"41","author":"M Checchi","year":"2023","unstructured":"Checchi, M. et al. The impact of over ten years of HPV vaccination in england: surveillance of type-specific HPV in young sexually active females. Vaccine 41, 6734\u20136744 (2023).","journal-title":"Vaccine"},{"key":"34501_CR14","doi-asserted-by":"publisher","first-page":"1590","DOI":"10.1093\/infdis\/jiy075","volume":"217","author":"DA Machalek","year":"2018","unstructured":"Machalek, D. A. et al. Very low prevalence of vaccine human papillomavirus types among 18- to 35-year old Australian women 9 years following implementation of vaccination. J. Infect. Dis. 217, 1590\u20131600 (2018).","journal-title":"J. Infect. Dis."},{"key":"34501_CR15","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1093\/infdis\/jis660","volume":"207","author":"PE Gravitt","year":"2013","unstructured":"Gravitt, P. E. et al. A cohort effect of the sexual revolution May be masking an increase in human papillomavirus detection at menopause in the united States. J. Infect. Dis. 207, 272\u2013280 (2013).","journal-title":"J. Infect. Dis."},{"key":"34501_CR16","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1097\/PGP.0b013e3181f38dfe","volume":"30","author":"CM Roteli-Martins","year":"2011","unstructured":"Roteli-Martins, C. M. et al. Prevalence of human papillomavirus infection and associated risk factors in young women in Brazil, Canada, and the united states: a multicenter cross-sectional study. Int. J. Gynecol. Pathol. 30, 173\u2013184 (2011).","journal-title":"Int. J. Gynecol. Pathol."},{"key":"34501_CR17","doi-asserted-by":"publisher","first-page":"e0229154","DOI":"10.1371\/journal.pone.0229154","volume":"15","author":"V Colpani","year":"2020","unstructured":"Colpani, V. et al. Prevalence of human papillomavirus (HPV) in brazil: A systematic review and meta-analysis. Plos One. 15, e0229154. https:\/\/doi.org\/10.1371\/journal.pone.0229154 (2020).","journal-title":"Plos One"},{"key":"34501_CR18","doi-asserted-by":"publisher","unstructured":"Wendland, E. M. et al. Prevalence of HPV infection among sexually active adolescents and young adults in brazil: the POP-Brazil study. Sci. Rep. 10 https:\/\/doi.org\/10.1038\/s41598-020-61582-2 (2020).","DOI":"10.1038\/s41598-020-61582-2"},{"key":"34501_CR19","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1055\/s-0038-1660841","volume":"40","author":"JC Teixeira","year":"2018","unstructured":"Teixeira, J. C., Maestri, C. A., Machado, H. D. C., Zeferino, L. C. & Carvalho, N. S. Cervical cancer registered in two developed regions from brazil: upper limit of reachable results from opportunistic screening. Rev. Bras. Ginecol. Obstet. 40, 347\u2013353 (2018).","journal-title":"Rev. Bras. Ginecol. Obstet."},{"key":"34501_CR20","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1186\/s12889-020-08688-4","volume":"20","author":"JC Teixeira","year":"2020","unstructured":"Teixeira, J. C. et al. Cervical cancer screening program based on primary DNA-HPV testing in a Brazilian city: a cost-effectiveness study protocol. BMC Public. Health. 20, 576. https:\/\/doi.org\/10.1186\/s12889-020-08688-4 (2020).","journal-title":"BMC Public. Health"},{"key":"34501_CR21","doi-asserted-by":"publisher","first-page":"e0251688","DOI":"10.1371\/journal.pone.0251688","volume":"16","author":"DB Vale","year":"2021","unstructured":"Vale, D. B. et al. Is the HPV-test more cost-effective than cytology in cervical cancer screening? An economic analysis from a middle-income country. PLoS One. 16, e0251688. https:\/\/doi.org\/10.1371\/journal.pone.0251688 (2021).","journal-title":"PLoS One"},{"key":"34501_CR22","doi-asserted-by":"publisher","first-page":"20761","DOI":"10.1038\/s41598-024-71735-2","volume":"14","author":"JC Teixeira","year":"2024","unstructured":"Teixeira, J. C. et al. Transition from opportunistic cytological to organized screening program with DNA-HPV testing detected prevalent cervical cancers 10 years in advance. Sci. Rep. 14, 20761. https:\/\/doi.org\/10.1038\/s41598-024-71735-2 (2024).","journal-title":"Sci. Rep."},{"key":"34501_CR23","unstructured":"Minister of Health. Brazil. Cervical Cancer Screening (Brazilian Guideline). (2025). Available at https:\/\/www.gov.br\/saude\/pt-br\/assuntos\/pcdt\/r\/rastreamento-cancer-do-colo-do-utero\/view"},{"key":"34501_CR24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jadohealth.2008.07.009","volume":"43","author":"JS Smith","year":"2008","unstructured":"Smith, J. S., Melendy, A., Rana, R. K. & Pimenta, J. M. Age-specific prevalence of infection with human papillomavirus in females: a global review. J. Adolesc. Health. 43, 1\u201341. https:\/\/doi.org\/10.1016\/j.jadohealth.2008.07.009 (2008). (4 Suppl), S5-25, S25.e.","journal-title":"J. Adolesc. Health"},{"key":"34501_CR25","doi-asserted-by":"publisher","first-page":"9374","DOI":"10.1038\/s41598-025-92102-9","volume":"15","author":"Q Ke","year":"2025","unstructured":"Ke, Q. et al. Multicenter study on the distribution and prevalence of human papillomavirus types in Hangzhou, Zhejiang from 2017 to 2023. Sci. Rep. 15, 9374. https:\/\/doi.org\/10.1038\/s41598-025-92102-9 (2025).","journal-title":"Sci. Rep."},{"key":"34501_CR26","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1590\/1516-3180.2018.0306220719","volume":"137","author":"JC Teixeira","year":"2019","unstructured":"Teixeira, J. C., Maestri, C. A., Machado, H. D. C., Zeferino, L. C. & Carvalho, N. S. Incidence rates and Temporal trends of cervical cancer relating to opportunistic screening in two developed metropolitan regions of brazil: a population-based cohort study. Sao Paulo Med. J. 137, 322\u2013328 (2019).","journal-title":"Sao Paulo Med. J."},{"key":"34501_CR27","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/j.ygyno.2021.04.027","volume":"162","author":"S Dilley","year":"2021","unstructured":"Dilley, S., Huh, W., Blechter, B. & Rositch, A. F. It\u2019s time to re-evaluate cervical cancer screening after age 65. Gynecol. Oncol. 162, 200\u2013202 (2021).","journal-title":"Gynecol. Oncol."},{"key":"34501_CR28","doi-asserted-by":"publisher","first-page":"e1004253","DOI":"10.1371\/journal.pmed.1004253","volume":"20","author":"M Tranberg","year":"2023","unstructured":"Tranberg, M. et al. Value of a catch-up HPV test in women aged 65 and above: A Danish population-based nonrandomized intervention study. PLoS Med. 20, e1004253. https:\/\/doi.org\/10.1371\/journal.pmed.1004253 (2023).","journal-title":"PLoS Med."},{"key":"34501_CR29","doi-asserted-by":"publisher","first-page":"1456","DOI":"10.1111\/1471-0528.17831","volume":"131","author":"JC Davies","year":"2024","unstructured":"Davies, J. C. et al. Urine high-risk human papillomavirus testing as an alternative to routine cervical screening: A comparative diagnostic accuracy study of two urine collection devices using a randomised study design trial. BJOG 131, 1456\u20131464 (2024).","journal-title":"BJOG"},{"key":"34501_CR30","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1186\/s12916-025-04149-0","volume":"23","author":"M Tranberg","year":"2025","unstructured":"Tranberg, M. et al. High-risk human papillomavirus testing in first-void urine as a novel and non-invasive cervical cancer screening modality-a Danish diagnostic test accuracy study. BMC Med. 23, 327. https:\/\/doi.org\/10.1186\/s12916-025-04149-0 (2025).","journal-title":"BMC Med."},{"key":"34501_CR31","unstructured":"Gilham, C., Crosbie, E., Nedjai, B., Macleod, U. & Davies-Oliveira, J. Catch-up screen: offering an at-home urine HPV test to women aged\u2009>\u200965 in the UK. EUROGIN 2024, Stockholm, Sweden, March 13\u201316, Abstract 6957, page 9. (2004). https:\/\/www.eurogin.com\/content\/dam\/markets\/aest\/eurogin\/pdfs\/2024\/EUROGIN2024_Abstracts_FC.pdf"},{"key":"34501_CR32","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.5858\/arpa.LGT200570","volume":"136","author":"TM Darragh","year":"2012","unstructured":"Darragh, T. M. et al. The lower anogenital squamous terminology (LAST) standardization project for HPV-Associated lesions: background and consensus recommendations from the college of American pathologists and the American society for colposcopy and cervical pathology. Arch. Pathol. Lab. Med. 136, 1266\u20131297 (2012).","journal-title":"Arch. Pathol. Lab. Med."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-34501-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-34501-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-34501-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T10:04:43Z","timestamp":1770026683000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-34501-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,7]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["34501"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-34501-6","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,7]]},"assertion":[{"value":"17 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study is part of a larger research project that developed and implemented the PREVENTIVO program. The Research Ethics Committee of the University of Campinas approved this study (number 1045580; dated May 1, 2015). The Committee waived the need for informed consent. All study procedures were carried out in accordance with the approved research protocol and followed the regulatory standards of the National Health Council of Brazil. In 2017, the mayor of Indaiatuba sanctioned a law instituting the DNA-HPV test as the standard for screening, replacing conventional cytology in all public health systems. The research group had no contact with participants and accessed electronic database to generate a secondary spreadsheet for statistical analyses, without identifying subjects.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"4453"}}