China's Cervical Cancer Progress Stalls Amid Growing Disparities for Older and Rural Women

China's cervical cancer trends reveal a complex public health landscape where national stabilization masks persistent and growing disparities among vulnerable populations. According to research published in Cancer Biology & Medicine on September 15, 2025, the country's age-standardized incidence rate tripled from approximately 3 per 100,000 women in 2000 to over 10 per 100,000 by 2016, followed by a national plateau in both incidence and mortality rates. However, this overall stabilization conceals significant inequities that threaten progress toward global elimination targets.

The study (DOI: 10.20892/j.issn.2095-3941.2025.0386), conducted by researchers from the National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, analyzed data from 22 long-term cancer registries across China alongside international datasets from the International Agency for Research on Cancer. Using Joinpoint regression analysis, the research team documented an average annual increase of 6.5% in cervical cancer incidence through 2016, with concerning patterns emerging across demographic groups. Urban women under 35 years showed declining incidence after 2009, likely reflecting improved awareness and early detection efforts. In contrast, rural women aged 35–64 continued to experience increasing rates, while women aged 65 and older demonstrated steadily rising incidence and mortality across both urban and rural settings.

When compared internationally, China's progress lags significantly behind countries that have implemented comprehensive prevention strategies. Australia and the Republic of Korea have achieved consistent declines in cervical cancer through nationwide HPV vaccination programs combined with high-quality screening initiatives. Japan exhibited rising incidence patterns similar to China's earlier trends, while the Philippines showed stable incidence but increasing mortality rates. These international comparisons highlight the critical importance of integrated prevention approaches rather than fragmented interventions.

The research findings underscore the urgent need for policy recalibration to address the widening health equity gap. Professor Wenqiang Wei, corresponding author of the study, emphasized that "China's stabilization in cervical cancer rates is an encouraging signal, but we cannot overlook the inequities beneath it. Older women and those in rural regions remain at disproportionate risk, largely due to limited access to vaccination, screening, and timely treatment." Current coverage rates reveal substantial gaps in prevention, with only about half of women aged 35–64 receiving screening and less than 10% of girls completing HPV vaccination since its introduction in 2016.

The implications extend beyond China's borders, given that the country accounts for nearly one-fifth of the world's female population. China's progress is crucial to global cervical cancer elimination efforts, particularly the World Health Organization's "90-70-90" targets. Researchers recommend several strategic interventions to accelerate progress, including expanding school-based HPV vaccination programs, scaling up primary HPV testing with self-sampling options to improve accessibility, and ensuring standardized treatment protocols across healthcare levels. The integration of AI-assisted cytology and digital registries could further enhance early detection capabilities, while strengthened coordination between public health programs and local governments will be essential for narrowing the urban-rural gap.

As China approaches the projected peak of its national cervical cancer burden around 2040, the study provides critical evidence for refining the country's elimination roadmap. The findings suggest that achieving cervical cancer elimination will require not only technological advances but system-level equity measures to ensure every woman receives the same standard of preventive care regardless of geographic location or age. The research was supported by grants from the National Key Research and Development Program of China and the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, with the full study available at https://doi.org/10.20892/j.issn.2095-3941.2025.0386.