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Background <p>The infection of high-risk human papillomavirus (hr-HPV) and related cervical cancer have greatly threatened women’s health. However, the benefits of ongoing strategies in China remains unclear. Insufficient vaccine supply and excessive screening workload have hindered the widespread implementation of HPV immunization plans.</p> Methods <p>We constructed stratified mathematical models to simulate the transmission of hr-HPV among women under ongoing public health strategies, and calculated the incremental cost-utility ratio (ICUR) to compare the health-economics benefits among different intervention pathways, including different vaccine type and dose schedules, commonly recommended screening algorithms as well as an artificial intelligence (AI)-assisted thin-layer cytology test (TCT) method. The model parameters were calibrated according to real-world HPV prevalences, incorporating segmented model assumptions reflecting the levels of COVID-19 lockdown.</p> Results <p>The model shows that ongoing strategies in China are projected to reduce cervical cancer prevalence continuously and demonstrate cost-utility (ICUR: 27,592.62 USD/quality-adjusted life-year [QALY], 26,902.80–28,282.44) when increasing the participation rate to achieve the global goal by 2030. HPV vaccination provides substantial health benefits but cannot improve the cost-utility at current cost. Offering single dose of 2vHPV vaccine to girls before the age of 14 and reallocating excess doses to women under 25 yields a lower ICUR compared to two- or three-dose scenarios. Cervical screening can significantly reduce the ICUR. Among the screening methods, HPV testing demonstrates higher cost-utility, while AI-TCT outperforms all recommended traditional pathways.</p> Conclusions <p>The ongoing strategies demonstrate substantial health and economic benefits in achieving the 2030 global target; however, neither screening nor vaccination alone can deliver optimal effectiveness. The findings highlight the importance of combining vaccination and screening, and provide evidence for the promotion of single-dose vaccination and AI-TCT projects to alleviate resource burdens.</p>

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Modelling the epidemic dynamics of HPV among women in China and optimization of ongoing cervical cancer elimination strategies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月22日

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  • Yuwei Li,
  • Yi-Fan Lin,
  • Boyu Cai,
  • Fangfang Chen,
  • Quanfu Zhang,
  • Siyang Liu,
  • Jianxin Zhen

摘要

Background

The infection of high-risk human papillomavirus (hr-HPV) and related cervical cancer have greatly threatened women’s health. However, the benefits of ongoing strategies in China remains unclear. Insufficient vaccine supply and excessive screening workload have hindered the widespread implementation of HPV immunization plans.

Methods

We constructed stratified mathematical models to simulate the transmission of hr-HPV among women under ongoing public health strategies, and calculated the incremental cost-utility ratio (ICUR) to compare the health-economics benefits among different intervention pathways, including different vaccine type and dose schedules, commonly recommended screening algorithms as well as an artificial intelligence (AI)-assisted thin-layer cytology test (TCT) method. The model parameters were calibrated according to real-world HPV prevalences, incorporating segmented model assumptions reflecting the levels of COVID-19 lockdown.

Results

The model shows that ongoing strategies in China are projected to reduce cervical cancer prevalence continuously and demonstrate cost-utility (ICUR: 27,592.62 USD/quality-adjusted life-year [QALY], 26,902.80–28,282.44) when increasing the participation rate to achieve the global goal by 2030. HPV vaccination provides substantial health benefits but cannot improve the cost-utility at current cost. Offering single dose of 2vHPV vaccine to girls before the age of 14 and reallocating excess doses to women under 25 yields a lower ICUR compared to two- or three-dose scenarios. Cervical screening can significantly reduce the ICUR. Among the screening methods, HPV testing demonstrates higher cost-utility, while AI-TCT outperforms all recommended traditional pathways.

Conclusions

The ongoing strategies demonstrate substantial health and economic benefits in achieving the 2030 global target; however, neither screening nor vaccination alone can deliver optimal effectiveness. The findings highlight the importance of combining vaccination and screening, and provide evidence for the promotion of single-dose vaccination and AI-TCT projects to alleviate resource burdens.