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High-risk human papillomavirus genotype distribution and attribution to cervical lesions in a Shanxi Province screening populationRu Shi 1,3,4 , Wenjuan Qi 2,4 , Zehua Wang 2 , Jing Cai 2 , Min Zhao 3 & Zanhong Wang 1?To characterize the hrHPV genotype distribution and attribution to cervical lesions in the cohort of women screened in Shanxi Province. Data from the records of cervical cancer screening programs for rural women in Shanxi Province were retrospectively collected. Women who underwent primary human papillomavirus (HPV) screening between January 2014 and December 2019 were included. The attribution proportion of specif i c hrHPV types for dif f erent grades of cervical lesions was calculated by using the type contribution weighting and the proportional attribution methods to estimate the potential impact of HPV vaccines on CIN II + lesions. CIN II + lesions were observed mainly with HPV16 (65.85%), HPV18 (10.20%), HPV58 (10.20%), HPV52 (7.98%), HPV31 (4.66%), HPV33 (4.43%), HPV51 (2.22%) and HPV56 (2.22%). A total of 97.42% of all CIN II + lesions were attributed to HPV16, HPV18, HPV52, HPV58, HPV31, HPV33 and HPV35. A total of 75.4% (95% CI, 71.4–79.3) of CIN II + lesions were attributable to HPV16/18, and 21.1% (95% CI, 17.4–25.1) were attributable to the 5 additional types (HPV31/33/45/52/58) covered by the 9-valent vaccine. The prevalence of hrHPV infection among women in Shanxi Province was high, and HPV16, HPV18, HPV58, HPV52, HPV31, HPV33 and HPV35 had the highest attributable proportion of CIN II + lesions. The type-specif i c HPV prevalence and attribution proportion of cervical precancerous lesions should be taken into consideration in both clinical management and the design of preventive strategies.Keywords Human papillomavirus, HPV genotyping, Cervical intraepithelial neoplasia, Attribution proportion, Cervical cancerAbbreviationsCIN II+ Cervical intraepithelial neoplasia grade II and aboveHPV Human papillomavirushrHPV High-risk human papillomavirusACS American Cancer SocietyOR Odds ratioCI Conf i dence intervalASCCP American Society for Colposcopy and Cervical PathologyASCP American Society for Clinical PathologyICC Invasive cervical carcinomaAIS  Adenocarcinoma in situVIA/VILI visual inspection with acetic acid and lugol’s lodine1 Department of Obstetrics and Gynecology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China. 2 Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. 3 Department of Obstetrics and Gynaecology, Shanxi Children’s Hospital, Shanxi Maternal and Child Health Hospital, 13Xinmin North Street, 030001 Taiyuan, Shanxi, China. 4 These authors contributed equally to this work: Wenjuan Qi and Ru Shi. ? email: wangzanhong@126.comOPENScientif i c Reports | (2025) 15:28217 1 | https://doi.org/10.1038/s41598-025-14228-0www.nature.com/scientificreports