Epidemiology and prevention of human papillomavirus and cervical cancer in China and Mongolia.

To develop a comprehensive intervention policy for future management of cervical cancer in China and Mongolia, it is essential to review the prevalence of human papillomavirus (HPV) infection, cervical cancer incidence and mortality, status of cervical screening and issues related to prophylactic HPV vaccines. Invasive cervical cancer (ICC) remains an important health problem among women in both China and Mongolia. However, a significant proportion of the burden is observed in rural settings. In areas of China and Mongolia where data are available, HPV prevalence is relatively high, with sexual activity being the most important risk factor. Nationwide programs for cervical cancer screening do not exist, and the majority of women have never been screened. However, government and non-governmental organizations have been collaborating to establish demonstration centers in both high- and low-resource settings to provide screening and obtain geographic specific data. To date, the prophylactic HPV vaccines are not licensed in China or Mongolia, although with wide coverage, the HPV vaccine could potentially prevent as much as three quarters of ICC cases among Chinese and Mongolian women. Ultimately, the introduction of HPV vaccination will present specific challenges, as well as opportunities, for developing advocacy, information and communication strategies that will involve policymakers and the general public.