To assess the possible reason of high incidence and mortality of cervical cancer in Longnan, China. 147 and 124 invasive squamous cell carcinoma (SCC) samples from Longnan and different cities and districts of Gansu province were collected in the present study. All the samples were obtained from patients who underwent biopsies with colposcopy or advanced operations and were evaluated by experienced pathologists. HPV genotypes were examined with a validated HPV subtypes kit. The prevalence of

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... infection in SCC patients of China was analyzed by evidence-based medicine in published literature. The markers of DNA damage response (DDR) - ATMpSer1981, H2AXp Ser139 (γH2AX), Chk2pThr68 and P53 - were analyzed by immunohistochemistry. HPV positivity, high risk and multiple HPV positivity and HPV 58 infection were significantly higher in Longnan. Our results the prevalence of HPV infection in SCC patients of Longnan are consistent with the HPV prevalence in China. ATM, γH2AX and P53 expression in total and HPV+ samples were also higher in Longnan. HPV related DDR activation may be one reason for high incidence and mortality of Longnan cervical cancer.