The burden of cervical cancer in China: Synthesis of the evidence
- 10 June 2011
- journal article
- research article
- Published by Wiley in International Journal of Cancer
- Vol. 130 (3), 641-652
- https://doi.org/10.1002/ijc.26042
Abstract
The burden of cervical cancer in China has not been characterized in detail. We reviewed cervical cancer data from national mortality surveys and registries, and conducted a meta‐analysis to estimate the prevalence of high‐grade lesions (HSIL) and high‐risk human papillomavirus (HR‐HPV) infections in rural Shanxi Province. We found that a national survey in the 1970s estimated age‐standardized cervical cancer mortality rates as ∼15 and ∼83/100,000 women nationally and in Xiangyuan, Shanxi; but the latest survey (2004–2005) found much lower rates of ∼3 and ∼7/100,000, respectively. IARC registries record age‐standardized cervical cancer incidence in China as <5/100,000 (1998–2002); but the five registry sites cover <2% of the population, and the gross domestic product per capita at each of the registry sites is higher than China's average (by a factor ranging from 1.3 to 3.9). The pooled estimate of the prevalence of HSIL and HR‐HPV in women aged 30–54 years in Shanxi was 3.7%(95%CI:2.7–4.8%) and 17.2%(95%CI:13.1–21.3%), respectively. Based on a feasible range informed by the incidence data for China and other unscreened populations, the predicted indicative annual number of new cervical cancer cases nationally, in the absence of any intervention, ranges from ∼27,000 to 130,000 (2010) to 42,000 to 187,000 (2050). In conclusion, recent data suggest comparatively low rates of cervical cancer incidence in China, which may be partly explained by the location of registry sites in higher socioeconomic status areas. However, the evidence is consistent with considerable heterogeneity within China, with a higher disease burden in some rural areas such as Shanxi. Therefore, the lower reported rates of cervical cancer in China should be interpreted cautiously.Keywords
This publication has 24 references indexed in Scilit:
- Human papillomavirus testing and cervical cytology in primary screening for cervical cancer among women in rural China: Comparison of sensitivity, specificity, and frequency of referralInternational Journal of Cancer, 2010
- HPV infection in women with and without cervical cancer in Conakry, GuineaBritish Journal of Cancer, 2009
- Different cervical cancer screening approaches in a Chinese multicentre studyBritish Journal of Cancer, 2009
- A new HPV-DNA test for cervical-cancer screening in developing regions: a cross-sectional study of clinical accuracy in rural ChinaThe Lancet Oncology, 2008
- Human Papillomavirus Infection in Ulaanbaatar, Mongolia: A Population-Based StudyCancer Epidemiology, Biomarkers & Prevention, 2008
- Human papillomavirus infection in Shenyang City, People's Republic of China: a population-based studyBritish Journal of Cancer, 2006
- Human papillomavirus infection in Shanxi Province, People's Republic of China: a population-based studyBritish Journal of Cancer, 2006
- Prevalence of Human Papillomavirus Infection Among Women in Concordia, Argentina:Sexually Transmitted Diseases, 2003
- Population‐Based Human Papillomavirus Prevalence in Lampang and Songkla, ThailandThe Journal of Infectious Diseases, 2003
- Human papillomavirus infection among women in South and North VietnamInternational Journal of Cancer, 2003