Prevention of human papillomavirus (HPV) infection and cervical cancer in China: how does HPV vaccination bring about benefits to Chinese women?

Cervical cancer is the second leading cause of cancer deaths among women in the world and more than 85% of cervical cancer cases occur in women living in developing countries. Human papillomavirus (HPV) infection is the major cause of cervical cancer. Since 2006, two prophylactic vaccines against the high-risk strains of HPV have been developed and approved in more than 100 countries around the world. However, in China, HPV vaccines are still under clinical trials for government approval. In this paper feasibility and justification of HPV vaccine introduction into China is examined by reviewing experiences in both developed and developing countries where the vaccination program has been implemented. The vaccination program has showed significant cost-effectiveness and great health and economic impacts on cervical cancer prevention and control in both high-income and middle- and low-income countries. On the other hand, based on the lessons from both developed and developing countries, secondary prevention alone cannot fully play a role to reduce the incidence and the disease burden, and neither does the vaccination program. The epidemiological characteristics in China suggest an urgent need to introduce the vaccines and the geographically diversified prevalence of oncogenic HPV types as well as socioeconomic status also highlight the importance of region-driven approaches for cervical cancer prevention and control by integration of a screening and vaccination program.