Cervical Cancer Screening Rates AmongChinese Women — China, 2023–2024

Mei Zhang¹;Limin Wang²; Xiao Zhang¹; Chun Li¹; ZhenpingZhao¹; Mengting Yu¹; Maigeng Zhou²; Jing Wu^2,#;Linhong Wang²

1. Division of NCD and Risk FactorSurveillance, National Center for Chronic and Noncommunicable Disease Controland Prevention, Chinese Center for Disease Control and Prevention, Beijing,China;

2. National Center for Chronic andNoncommunicable Disease Control and Prevention, Chinese Center for DiseaseControl and Prevention, Beijing, China.

Corresponding authors:Jing Wu, wujing@ncncd.chinacdc.cn.

The Chinese government hasestablished targets of 50% cervical cancer screening coverage by 2025 and 70%by 2030 for women of appropriate age. This study aimed to assess screeningcoverage across China and analyze key sociodemographic and geographicdeterminants. A nationally and provincially representative cross-sectionalsurvey was conducted among adults from 31 provincial-level administrativedivisions in China between August 2023 and May 2024. Following data cleaning,96,819 female participants were included in the analysis. Cervical cancerever-screening rates were calculated for the overall population and by subgroups.All results were weighted to provide more accurate population-level estimates. In2023–2024, 51.5% of women aged 35–64 years had undergone cervical cancerscreening at least once, with rates of 57.9% among women aged 35–44 years and36.8% among women aged 20 years and above. Screening coverage in rural areas(48.2%) remained slightly below but approached the 50% target. Several regions(specifically, the Eastern, Central, and Southern regions) have achieved the2025 target. Significant determinants of cervical cancer screening adherenceamong Chinese women encompass higher educational attainment, employed, elevatedhousehold income, health insurance coverage, and health check-ups (P<0.05for all comparisons). Intensified efforts are needed to implement the ActionPlan to Accelerate Elimination of Cervical Cancer, particularly in rural areas.Additionally, enhanced health education and service provision should targetwomen of lower socioeconomic status to promote their active participation inscreening programs.

女性宫颈癌筛查率分析 — 中国，2023–2024年

张梅¹；王丽敏²；张笑¹；李纯¹；赵振平¹；于梦婷¹；周脉耕²；吴静^2,#；王临虹²

1.慢病危险因素监测室，中国疾病预防控制中心慢性非传染性疾病预防控制中心，北京，中国；

2.中国疾病预防控制中心慢性非传染性疾病预防控制中心，北京，中国。

^# 通信作者:吴静，wujing@ncncd.chinacdc.cn。

中国政府设定了2025年适龄妇女宫颈癌筛查覆盖率达到50%，2030年达到70%的目标。本研究旨在评估中国大陆全国及各省份的筛查覆盖率，并分析相关社会人口学和地理因素。研究数据来自2023年8月至2024年5月期间，在中国31个省级行政区开展的一项兼具国家和省级代表性的针对成年人的横断面调查。经过数据清理后，共纳入96,819名女性参与者。分析了总体及各亚组的宫颈癌筛查率。所有结果均经过加权处理，以更准确地估计总体人群的筛查情况。2023-2024年，我国35-64岁女性的筛查率为51.5%，35-44岁女性的筛查率为57.9%，20岁及以上女性的筛查率为36.8%。农村地区的筛查覆盖率（48.2%）仍低于但接近50%的目标。一些区域，尤其华东、华中和华南地区的筛查率已达到2025年目标。与更高的筛查率有关的因素包括较高的教育水平、有工作、更高的收入、保险覆盖以及健康体检。应加大力度实施《加速消除宫颈癌行动计划》，特别是在农村地区和筛查率较低的省级行政区。同时，应加强对社会经济地位较低女性的健康教育和服务，促进她们积极参与筛查。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.052

Association Between High-Risk HumanPapillomavirus Infection and Cervical Cytology in Health Check-Up Women — 23PLADs, China, 2023

Di Gao¹;Gengli Zhao¹; Xueyin Wang¹; Juan Juan¹; YupengShi²; Taoye Xu²; Yue Wang²; Linhong Wang^3,#;Xiaosong Zhang^1,#

1. Department of Obstetrics and Gynecologyand Reproductive Medicine, Peking University First Hospital, Beijing, China;

2. Hangzhou Dian Medical Laboratory Center,Hangzhou City, Zhejiang Province, China;

3. National Center for Chronic andNon-Communicable Disease Control and Prevention, Chinese Center for DiseaseControl and Prevention, Beijing, China.

^#Corresponding authors: Xiaosong Zhang,zhangxiaosong@bjmu.edu.cn; Linhong Wang, linhong@chinawch.org.cn.

Human papillomaviruses (HPV) testing andliquid-based cytology (LBC) are the primary screening methods for cervicalcancer. However, recent nationwide data on HPV distribution across differentcytological conditions in China remains limited. This nationwidecross-sectional study analyzed health check-up data from the Dian laboratorynetwork across China in 2023. The study included 238,807 women aged ≥20 yearsfrom 23 Provincial-level administrative divisions (PLADs) who underwent bothHPV genotyping and LBC testing. The rates of abnormal cytology and HPVinfection were weighted and standardized according to the Seventh NationalPopulation Census (2020). The overall weighted rates of HR-HPV infection andabnormal cytology were 12.30% and 9.25%, respectively. Among women withabnormal cervical cytology, HPV-16 was the most prevalent HR-HPV genotype,followed by HPV-58 and HPV-52. The detection rates of HR-HPV and abnormalcytology remain relatively high in China. Both single and multiple HR-HPVinfections were associated with increased risk of abnormal cervical cytology.These findings may inform the development of HPV genotype-specific vaccinationand screening strategies to reduce cervical cancer burden.

女性体检人群高危型人乳头瘤病毒感染与宫颈细胞学的关联研究 — 23省份，中国，2023年

高迪¹；赵更力¹；王雪茵¹；隽娟¹；师玉鹏²；许陶冶²；王玥²；王临虹^3,#；张小松^1,#

1. 妇产生殖医学中心，北京大学第一医院，北京，中国；

2. 杭州迪安医学检验中心，浙江，中国；

3. 慢性非传染性疾病预防控制中心，中国疾病预防控制中心，北京，中国。

^#通信作者：张小松，zhangxiaosong@bjmu.edu.cn；王临虹，linhong@chinawch.org.cn。

宫颈癌是严重威胁全球女性健康的恶性肿瘤之一，其发病率和死亡率居第四位，尤其是在中低收入国家。目前，人乳头瘤病毒（HPV）检测和宫颈液基细胞学（LBC）检查是宫颈癌筛查的主要方法。然而，自从2017年HPV疫苗在中国上市后，缺乏全国范围内不同细胞学状况下高危型HRV（HR-HPV）分布的最新数据。本研究采用横断面研究设计，基于2023年迪安实验室的全国健康体检数据库，了解人群HR-HPV感染和宫颈细胞学检查异常情况。研究最终纳入了来自中国23个省的238,807名≥20岁女性，并且同时进行了HPV基因分型检测和LBC检查。宫颈细胞学标化异常率和HR-HPV标化感染率均根据2020年第七次全国人口普查的数据进行了加权。HR-HPV标化感染和异常细胞学的总体加权率分别为12.30%和9.25%。在宫颈细胞学异常的女性中，最常见的HR-HPV基因型是HPV-16，其次是HPV-58和HPV-52。尤其是在细胞学宫颈高级别鳞状上皮内病变（HSIL）者中，HPV-16的感染率远高于其他高危型别。本研究发现，中国HR-HPV和异常细胞学的检出率仍然相对较高。HR-HPV单一和多重感染者的宫颈细胞学异常风险更高。研究结果有助于制定HPV基因型特异性疫苗接种和筛查策略，以减轻宫颈癌的负担。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.053

Prevalence and Severity of MenopausalSymptoms in Women of Different Ages — China, 2023–2024

Zhenghua Yong¹; Yehuan Yang²;Yilin Yang¹; Li Yang²; Yanxia Zhao²; XiaominLuo²; Mengke Yan¹; Ruimin Zheng^2,#

¹ ChineseCenter for Disease Control and Prevention, Beijing, China;

² NationalCenter for Women and Children’s Health, National Helath Commission of thePeople’s Republic of China, Beijing, China.

^# Correspondingauthor: Ruimin Zheng, zhengruimin@ncwchnhc.org.cn.

To investigate the prevalence and severityof menopausal symptoms among Chinese women aged 40–60 years and provideevidence for developing personalized health management strategies. Using amulti-stage stratified cluster sampling approach, we conducted a nationwidecross-sectional survey across representative provincial-level administrativedivisions (PLADs) and prefecture-level cities, encompassing 26 district/countysurvey sites. The questionnaire collected information on demographiccharacteristics, menopausal status, and symptoms. Data analysis employed meansand standard deviations () or ratesand proportion ratios to describe menopausal symptom occurrence, with groupdifferences analyzed using Mann-Whitney or Kruskal-Wallis tests. The studyincluded 42,304 women with a mean age of 49.9±5.7 years. The overall prevalenceof menopausal symptoms was 46.3% [95% confidence interval (CI): 45.8%, 46.7%],predominantly mild to moderate in severity. The prevalence of mild to severesymptoms began increasing in women over age 44, peaking at age 52. Moderate tosevere symptoms showed an uptick after age 46, also peaking at 52 years, whilesevere symptoms increased after age 48, reaching maximum prevalence at age 56.The most commonly reported symptoms were insomnia (50.0%, 95% CI: 49.5%, 50.5%), fatigue (48.2%, 95% CI: 47.7%, 48.7%), and nervousness(46.9%, 95% CI: 46.5%, 47.4%).Significant differences in symptom severity between premenopausal andpostmenopausal women were observed in the 45–49 (P<0.001) and 50–54 (P=0.019,<0.05) age groups. The study revealed distinct patterns in the prevalence,severity, and manifestation of menopausal symptoms across different age groupsin China. The age-related progression of symptoms provides a scientificfoundation for developing targeted healthcare interventions for women atvarious stages of menopause.

不同年龄女性更年期症状的患病率及其严重程度 — 中国，2023–2024年

勇正华¹；杨业环²；杨艺林¹；杨丽²；赵艳霞²；罗晓敏²；闫梦可¹；郑睿敏^2,#

1. 中国疾病预防控制中心，北京，中国；

2. 妇幼健康中心，国家卫生健康委，北京，中国。

^#通信作者:郑睿敏，zhengruimin@ncwchnhc.org.cn。

描述我国40–60岁女性更年期症状的患病率及其严重程度，为制定个性化的健康管理策略提供依据。采用多阶段分层整群随机抽样的方法，抽取具有代表性的省和地级市开展全国性横断面调查，共纳入26个区/县调查点。问卷包括人口学特征、绝经状况、更年期症状等信息。采用均数及标准差（）或率及构成比描述更年期症状的发生情况，采用Mann-Whitney检验或 Kruskal-Wallis检验分析组间差异性。本研究共纳入42304名女性，平均年龄（49.9±5.7）岁，更年期症状患病率为46.3% (95% CI: 45.8%, 46.7%)，以轻中度为主。44岁以上女性轻至重度症状患病率开始增加，在52岁时达到高峰，46岁以上女性中至重度症状患病率开始增加，在52岁时达到高峰，48岁以上女性重度症状患病率开始增加，在56岁时达到高峰。最常见的更年期症状是失眠（50.0%，95% CI： 49.5%, 50.5%）、疲乏（48.2%，95% CI: 47.7%, 48.7%）、情绪波动（46.9%，95% CI：46.5%, 47.4%）。45–49（P < 0.001） 和50–54（P=0.019, <0.05）两个年龄组未绝经与已绝经女性更年期症状严重程度之间的差异有统计学意义。研究结果表明，中国不同年龄组女性更年期症状的患病率、严重程度及常见症状存在差异，更年期症状随年龄增长存在一定的变化规律，结果可为制定处于更年期不同年龄段的女性保健措施提供科学依据。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.054

Female Breast Cancer Incidence andAssociation with Socioeconomic Status in a Population-Based Cohort — China,2018–2024

Heling Bao^1,&;Liwen Fang^2,&; Shu Cong²; Xiaolei Guo³;Zhentao Fu³; Xiaoli Liu⁴; Weiwei Shi⁴; HongjianLiu⁵; Hui Liu^1,#; Xuening Duan^6,#; LinhongWang^2,#

1. Institute of MedicalInformation, Chinese Academy of Medical Sciences & Peking Union MedicalCollege, Beijing, China;

2. National Center for Chronicand Non-communicable Disease Control and Prevention, Chinese Center forDisease Control and Prevention,Beijing, China;

3. Shandong Center forDisease Control and Prevention, Jinan City, Shandong Province, China;

4. Hebei Center for DiseaseControl and Prevention, Shijiazhuang City, Hebei Province, China;

5. Taixing Center forDisease Control and Prevention, Taizhou City, Zhejiang Province, China;

6. Peking University FirstHospital, Beijing, China.

^&Joint first authors.

^# Corresponding author: Hui Liu, liuhui@pumc.edu.cn, Xuening Duan, duanxuening@pku.edu.cn,Linhong Wang, linhong@chinawch.org.cn.

Breast cancer has emerged asthe most prevalent cancer among women globally. However, the relationshipbetween individual socioeconomic status (SES) and breast cancer risk remainsincompletely understood. This population-based cohort study recruited womenaged 30–70 years from Shandong, Hebei, and Jiangsu provinces in China during2008 and 2018. We developed a composite SES measure through latent classanalysis incorporating household income, education level, and health insurancetype, stratifying participants into low and high SES groups. Self-perceived SESwas evaluated using a Likert scale. We employed Cox proportional hazardsregression to estimate hazard ratios (HRs)and 95% confidence intervals (CIs)for the association between SES and breast cancer incidence. Among 62,350participants followed for an average of 6.1 person-years, we identified 300 incidentbreast cancer cases. The overall incidence rate was 48.9 per 100,000person-years. Women with high SES demonstrated significantly elevated breastcancer risk compared to those with low SES (HR=1.42,95% CI: 1.05, 1.92). Self-perceivedSES appeared to modify this relationship, with increased breast cancer riskobserved among women categorized as both objectively and subjectively low SES. Thesefindings underscore the need for SES-specific approaches to breast cancerscreening programs and targeted health education initiatives.

女性乳腺癌发病率及其与社会经济地位的关联 — 中国，2018-2024年

包鹤龄^1,&，方利文^2,&，丛舒²，郭晓雷³，付振涛³，刘晓丽⁴，史卫卫⁴，刘红建⁵，刘辉^1,#，段学宁^6,#，王临虹^2,#

1. 医学信息研究所，中国医学科学院，北京，中国；

2. 慢性非传染性疾病预防控制中心，中国疾病预防控制中心，北京，中国；

3. 山东省疾病预防控制中心, 济南市，山东省，中国；

4. 河北省疾病预防控制中心, 石家庄市，河北省, 中国；

5. 泰兴市疾病预防控制中心, 泰州市，浙江省, 中国；

6. 北京大学第一医院, 北京, 中国。

^&共同第一作者。

^#通信作者：刘辉，liuhui@pumc.edu.cn；段学宁，duanxuening@pku.edu.cn；王临虹，linhong@chinawch.org.cn。

乳腺癌已成为全球女性最常见的癌症。然而，个体社会经济地位（SES）与乳腺癌之间的关联仍是一个值得关注的问题。本项基于人群的乳腺癌队列研究于2008年和2018年在山东省、河北省和江苏省招募了30-70岁女性。研究采用潜类分析基于家庭人均收入、受教育水平及医疗保险类型构建综合的SES指标，并将研究对象分为低SES和高SES两类。使用李克特量表评估研究对象的自我感知SES。采用Cox比例风险回归模型计算乳腺癌与SES之间的风险比（HR）及其95%置信区间（CI）。本研究共纳入62,350名女性，平均随访6.1人年，共发现300例新发乳腺癌病例。乳腺癌发病率为48.9/10万人年。相比低SES女性，高SES女性乳腺癌风险显著增加（HR=1.42，95% CI：1.05, 1.92）。自我感知SES可能会调节这一效应，表现为客观SES和自我感知SES均较低的女性乳腺癌风险增加。未来应针对不同SES群体制定个性化的女性乳腺癌筛查和健康教育策略，优化乳腺癌的防控措施。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.055

Detection and BI-RADS Classification ofBreast Nodules in Urban Women — China, 2021

XiaoxiLiu^1,&; Yaxin Xing^2,&; YiningZu^3,&; Heling Bao¹; Xue Ding¹;Yongchao Chen¹; Canqing Yu^4,5,6,7; Jun Lyu^4,5,6,7; Linhong Wang⁸; Bo Wang^3,4,7; Sailimai Man^3,4,5,6,#; Liming Li^4,5,6,7,#; Hui Liu^1,#

1. Institute of Medical Information,Chinese Academy of Medical Sciences, Beijing, China;

2. Peking Union Medical College, Beijing,China;

3. Meinian Institute of Health, Beijing,China;

4. Peking University Health Science CenterMeinian Public Health Institute, Beijing, China;

5. Department of Epidemiology andBiostatistics, School of Public Health, Peking University, Beijing, China;

6. Key Laboratory of Epidemiology of MajorDiseases (Peking University), Ministry of Education, Beijing, China;

7. Peking UniversityCenter for Public Health and Epidemic Preparedness & Response, Beijing,China;

8. National Center for Chronic andNon-communicable Disease Control and Prevention, Chinese Center for DiseaseControl and Prevention, Beijing, China.

^&Joint first authors.

^# Corresponding author: Hui Liu, liuhui@pumc.edu.cn; Liming Li, lmlee@bjmu.edu.cn; SailimaiMan, sailimai.man@meinianresearch.com.

Female breast nodules represent the mostfrequently detected lesions during breast ultrasound screening. Notably,nodules classified as BI-RADS 4 or 5 indicate an elevated risk of breastcancer. Nevertheless, the detection rate and BI-RADS classification of femalebreast nodules across China remain largely undocumented. This study analyzedhealth examination data from 6,412,893 urban women across 31 provincial-leveladministrative divisions (PLADs). We calculated detection rates of breastnodules and their various BI-RADS classifications. Chi-square (χ²) tests were performed to comparedifferences between groups. Multivariable logistic regression models wereconstructed to explore associations between breast nodules and BI-RADS 4–5 withdemographic, socioeconomic, and metabolic indicators. The overall detectionrate of breast nodules in Chinese urban women was 27.9%, with provincial ratesranging from 11.6% to 37.0%. Among women with breast nodules marked withBI-RADS classification information, 95.9% were categorized as BI-RADS 2–3,while 4.0% were classified as BI-RADS 4–5. Further analyses revealed that age,geographic region, per capita gross domestic product (GDP), body mass index(BMI), high triglyceride (TG), high low-density lipoprotein cholesterol(LDL-C), and diabetes were significant risk factors for BI-RADS 4–5classification. This study highlights the importance of managing high-riskwomen with breast nodules through BI-RADS classification, underscoring the needfor targeted health interventions while considering regional and socioeconomicdisparities.

城市妇女乳腺结节检出率与BI-RADS分类情况 — 中国，2021年

刘晓曦^1,&；邢雅馨^2,&；祖一宁^3,&；包鹤龄¹；丁雪¹；陈永超¹；余灿清^4,5,6,7；吕筠^4,5,6,7；王临虹⁸；王波^3,4,7；满塞丽麦^3,4,5,6,#；李立明^4,5,6,7,#；刘辉^1#

1.医学信息研究所，中国医学科学院，北京，中国；

2.北京协和医学院，北京，中国；

3.美年健康产业研究院，北京，中国；

4.北京大学医学部美年公众健康研究院，北京，中国；

5.流行病学与生物统计学系，公共卫生学院，北京大学，北京，中国；

6.重大疾病流行病学教育部重点实验室（北京大学），北京，中国；

7.北京大学公众健康与重大疫情防控战略研究中心，北京，中国；

8. 慢性非传染性疾病预防控制中心，中国疾病预防控制中心，北京，中国。

^&共同第一作者。

^#通信作者：刘辉，liuhui@pumc.edu.cn；李立明，lmlee@bjmu.edu.cn；满塞丽麦，sailimai.man@meinianresearch.com。

女性乳腺结节是乳腺超声筛查中最常见的病变，特别是分类为BI-RADS 4或5的结节提示增高的恶性肿瘤风险。然而，目前中国女性乳腺结节检出率和BI-RADS分类情况仍然未知。本研究分析了来自全国31个省级行政区的6,412,893名城市女性的健康体检数据，计算了乳腺结节和不同BI-RADS分类的检出率。通过卡方检验比较了组间差异，建立多变量逻辑回归模型探讨女性乳腺结节及BI-RADS 4-5与人口统计学、社会经济和代谢指标的关系。中国城市女性乳腺结节总体检出率为27.9%，31个省级行政区的检出率处于11.6%-37.0%。在具有BI-RADS分类信息的乳腺结节女性中，95.9%为BI-RADS 2-3，4.0%为BI-RADS4-5。进一步的分析表明，年龄、地理区域、人均国内生产总值、体重指数、高甘油三酯、高低密度脂蛋白胆固醇和糖尿病是BI-RADS 4-5的危险因素。本研究强调了通过BI-RADS分类管理乳腺结节高危女性的重要性，亟需对高危女性实施有针对性的健康干预，并考虑地区和社会经济差异。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.056