The burden of cervical cancer in China: Synthesis of the evidence

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.

Efficacy of Pap Test in Combination with ThinPrep Cytological Test in Screening for Cervical Cancer

“…In 1970s, the mortality of cervical cancer patients was approximately 9.98/100000 in China, while a survey reported that during the period from 1990-1992 the mortality was reduced to 3.25/100000 (Cao 2002). Despite this reduction, data has shown that the incidence of cervical cancer increased 14% during the period from 2000-20005 (Yang et al, 2000Shi et al, 2012). There are about 493,100 new cases of cervical cancer annually worldwide, and 273,000 women die of cervical cancer .…”

“…Currently, China has the largest population with cervical cancer. (Yang et al, 2000;Parkin et al, 2005;Li and Kang, 2011;Shi et al, 2012). Thus, developing an applicable method and screening program in China is of great importance.…”

<b><i>c-myc</i></b> Gene Copy Number Variation in Cervical Exfoliated Cells Detected on Fluorescence in situ Hybridization for Cervical Cancer Screening

“…Cervical cancer remains the second most common cancer and the second most common cause of cancer-related death in China [9]. The main preventive measure against cervical cancer is cytology screening of exfoliated cervical cells.…”

Low folate levels are associated with methylation-mediated transcriptional repression of miR-203 and miR-375 during cervical carcinogenesis

“…Cervical cancer is the second most aggressive type of malignant tumor, and causes serious damage to women's health (22). Each year, there are ~150,000 newly diagnosed cases of cervical cancer in China, which accounts for almost 1/3 of the total cases worldwide (12).…”