China's cervical cancer rates have stabilized after years of increase, but disparities by age and geography are widening, according to a study published in Cancer Biology & Medicine on September 15, 2025. Researchers from the National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College analyzed data from 22 long-term cancer registries from 2000 to 2020, finding that the age-standardized incidence rate tripled from about 3 per 100,000 in 2000 to over 10 per 100,000 by 2016, then plateaued. Mortality rates followed a similar pattern. However, the national plateau masks troubling trends: rural women aged 35–64 years continue to see rising incidence, and women aged 65 years and older in both urban and rural areas face steadily increasing rates. In contrast, urban women under 35 years have experienced declining incidence since 2009, likely due to improved awareness and early detection.
The findings come as China accounts for nearly one-fifth of the world's female population, making its progress critical to the global effort to eliminate cervical cancer. Despite the introduction of HPV vaccination in 2016 and large-scale screening programs, coverage remains low. Only about half of women aged 35–64 have been screened, and less than 10% of girls have completed HPV vaccination. Persistent gaps in access, especially in rural and aging populations, limit progress toward the World Health Organization's "90-70-90" targets. The study's international comparison shows that countries like Australia and the Republic of Korea have achieved consistent declines through nationwide HPV vaccination and high-quality screening, while Japan and the Philippines have seen rising rates.
"China's stabilization in cervical cancer rates is an encouraging signal, but we cannot overlook the inequities beneath it," said Professor Wenqiang Wei, corresponding author of the study. "Older women and those in rural regions remain at disproportionate risk, largely due to limited access to vaccination, screening, and timely treatment. Achieving the WHO elimination goal will require not just technological advances but system-level equity—ensuring every woman, regardless of where she lives, receives the same standard of preventive care."
The study, funded by the National Key Research and Development Program of China and the Chinese Academy of Medical Sciences Innovation Fund, provides critical evidence for refining China's national cervical cancer elimination roadmap. Researchers recommend expanding school-based HPV vaccination, scaling up primary HPV testing with self-sampling options, and ensuring standardized treatment across healthcare levels. Integrating AI-assisted cytology and digital registries could further improve early detection. Strengthening coordination between public health programs and local governments will be vital to narrow the urban–rural gap. As China approaches the peak of its national burden around 2040, decisive and equitable interventions will determine whether the elimination of cervical cancer becomes a regional reality. The original study can be accessed at https://doi.org/10.20892/j.issn.2095-3941.2025.0386.
