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

International Journal of Cancer - Tập 130 Số 3 - Trang 641-652 - 2012
Jufang Shi1,2,3, Karen Canfell1,4,3,5,6, Jie‐Bin Lew1, You‐Lin Qiao2,4,7,6
1Cancer Epidemiology Research Unit, Cancer Council NSW, New South Wales, Australia
2Department of Cancer Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China
3School of Public Health, Sydney Medical School, University of Sydney, Australia
4Karen Canfell, Senior Research Fellow, Clinical Associate Professor, Cancer Epidemiology Research Unit, Cancer Council NSW, 153 Dowling Street, Woolloomooloo 2011, New South Wales, Australia
5Tel.: 612-93341852,
6You-Lin Qiao, Department of Cancer Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences, Beijing 100021, China
7Tel.: +86-10-8778-8489,

Tóm tắt

AbstractThe 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.

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International Journal of Cancer

Tập 130 Số 3

641-652

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