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ORIGINAL RESEARCH ARTICLE

Spatiotemporal disparities in cervical cancer screening in Hubei, China: Progress toward the World Health Organization’s 70% screening target

Dan-dan Yin1† ,  Zhike Wang2† ,  Dehai Li1† ,  Yanghuan Xu1 ,  Wenhua An3 ,  Mengmeng Shi4 ,  Yuxuan Lu1 ,  Kai Cheng1 ,  Ziyan Yin3 ,  Fan Zhang5 ,  Qiong Dai1*
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1 Department of Health, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
2 Department of Human Resources and Education, Hubei Province Center for Disease Control and Prevention, Wuhan, Hubei, China
3 Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
4 Department of Pharmacy, Wuhan Mental Health Center/Wuhan Psychological Hospital, Wuhan, Hubei, China
5 Department of Infectious Disease Prevention and Control Institute, Hubei Province Center for Disease Control and Prevention, Wuhan, Hubei, China
†These authors contributed equally to this work.
EJMO, 026070087 https://doi.org/10.36922/EJMO026070087
Received: 15 February 2026 | Revised: 20 April 2026 | Accepted: 27 April 2026 | Published online: 28 May 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Cervical cancer remains a major global health burden, while socioeconomic inequalities continue to hinder progress toward the World Health Organization (WHO)’s 70% screening target in China.

Objective: To examine the temporal trends and spatial distribution of cervical cancer incidence and screening coverage in Hubei Province, China, from 2015 to 2023, and identify geographical disparities to guide targeted public health interventions.

Methods: This retrospective, population-based study used cervical cancer screening data from the Hubei Provincial Cervical Cancer Screening Program. Temporal trends in screening coverage and detection rates were analyzed using joinpoint regression models. Spatial autocorrelation analyses, including Global Moran’s I and local indicators of spatial association, were performed to identify geographic clustering patterns.

Results: Screening coverage demonstrated a statistically significant upward trend from 2015 to 2023 (average annual percentage change [AAPC] = 28.21%, p < 0.001), with a marked acceleration in growth in 2021 (APC = 163.70%). However, only 23.7% of regions met the WHO’s target of 70% coverage, with the provincial average remaining at 52.90%. Significant spatial clustering of high screening coverage was observed throughout the study period (p < 0.05). In contrast, cervical cancer detection rates did not exhibit a significant overall upward trend (AAPC = 4.65%, p = 0.703). Spatial analysis identified emerging hotspots of elevated detection rates in 2023 (Moran’s I = 0.189, p = 0.007), primarily concentrated in the southwestern and northeastern regions.

Conclusion: This study demonstrates a significant increase in screening coverage following 2021; however, notable regional disparities persist in achieving the WHO’s 70% screening target. The analysis identifies emerging spatial hotspots that necessitate geographically tailored interventions. These findings provide a strategic framework for optimizing resource allocation to meet national and global cervical cancer elimination targets by 2030.

Keywords
Cervical cancer elimination
Screening coverage
World Health Organization’s targets
Spatial analysis
Health equity
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
References
  1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-249. doi: 10.3322/caac.21660

 

  1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-263. doi: 10.3322/caac.21834

 

  1. Wratsangka R, Hartanti MD, Purwoto G, Surjadi LM, Aulia MP, Kogoya A. Risk factors and human papillomavirus genotypes: Investigating their interplay in cervical cancer. Eurasian J Med Oncol. 2026;10(1):318-327. doi: 10.36922/EJMO025490509

 

  1. World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva: World Health Organization; 2020. Available from: https://www.who.int/publications/i/item/9789240014107 [Last accessed on May 9, 2026].

 

  1. National Health Commission of the People’s Republic of China. Action Plan for Accelerating the Elimination of Cervical Cancer (2023-2030). 2023. Available from: https://www.gov.cn/zhengce/zhengceku/2023-01/21/ content_5738364.htm [Last accessed on May 14, 2026].

 

  1. Simelela PN. WHO global strategy to eliminate cervical cancer as a public health problem: An opportunity to make it a disease of the past. Int J Gynaecol Obstet. 2021;152(1):1- 3. doi: 10.1002/ijgo.13484

 

  1. Xia C, Dong X, Li H, et al. Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chin Med J. 2022;135(5):584-590. doi: 10.1097/CM9.0000000000002108

 

  1. Li Z, Liu P, Yin A, et al. Global landscape of cervical cancer incidence and mortality in 2022 and predictions to 2030: The urgent need to address inequalities in cervical cancer. Int J Cancer. 2025;157(2):288-297. doi: 10.1002/ijc.35369

 

  1. Godiwala PN, Goldstein A, O’Keefe T, et al. Using a New Hand-Held Colposcope in Combination with Cryotherapy and LEEP in a See-and-Treat Cervical Cancer Screening Program. Eurasian J Med Oncol. 2019;3(4):257-262. doi: 10.14744/ejmo.2019.50315

 

  1. Pradhan P, Iyer HS, Rebbeck TR. Geographic and Temporal Patterns of Screening for Breast, Cervical, and Colorectal Cancer in the US, 1997-2019. JAMA Netw Open. 2025;8(10):e2537905. doi: 10.1001/jamanetworkopen.2025.37905

 

  1. Hou D, Wang X. Unveiling spatial disparities in basic medical and health services: insights from China’s provincial analysis. BMC Health Serv Res. 2024;24(1):329. doi: 10.1186/s12913-024-10798-3

 

  1. National Bureau of Statistics of China. Seventh National Population Census of the People’s Republic of China. 2021. Available from: https://www.stats.gov.cn/english/ PressRelease/202105/t20210510_1817186.html [Last accessed on May 14, 2026].

 

  1. World Health Organization. Framework for Monitoring the Implementation of the WHO Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem (Including indicator metadata). Geneva: WHO, 2023. Available from: https://www.who.int/teams/ noncommunicable-diseases/surveillance/systems-tools/ cervical-cancer [Last accessed on May 14, 2026].

 

  1. Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med. 2000;19(3):335-351. doi: 10.1002/(sici)1097-0258(20000215)19:3<335::aid-sim336>3.0.co;2-z

 

  1. Moran PAP. Notes on continuous stochastic phenomena. Biometrika. 1950;37(1/2):17-23. doi: 10.2307/2332142

 

  1. Yang L, Boily MC, Rönn MM, et al. Regional and country-level trends in cervical cancer screening coverage in sub- Saharan Africa: A systematic analysis of population-based surveys (2000-2020). PLoS Med. 2023;20(1):e1004143. doi: 10.1371/journal.pmed.1004143

 

  1. Zhou L, Li Y, Wang H, Qin R, Han Z, Li R. Global cervical cancer elimination: quantifying the status, progress, and gaps. BMC Med. 2025;23(1):67. doi: 10.1186/s12916-025-03897-3

 

  1. Simms KT, Steinberg J, Caruana M, et al. Impact of scaled up human papillomavirus vaccination and cervical screening and the potential for global elimination of cervical cancer in 181 countries, 2020-99: a modelling study. Lancet Oncol. 2019;20(3):394-407. doi: 10.1016/S1470-2045(18)30836-2

 

  1. Vahteristo M, Heinävaara S, Anttila A, Sarkeala T. Alternative cytology triage strategies for primary HPV screening. Gynecol Oncol. 2022;167(1):73-80. doi: 10.1016/j.ygyno.2022.07.023

 

  1. Wang R, Coleman JS. The HPV self-collection paradox: boosting cervical cancer screening, struggling with follow-up care. Lancet Public Health. 2023;8(6):e394-e395. doi: 10.1016/S2468-2667(23)00094-4

 

  1. Brisson M, Kim JJ, Canfell K, et al. Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries. Lancet. 2020;395(10224):575-590. doi: 10.1016/S0140-6736(20)30068-4

 

  1. Ren H, Xu R, Zhang J. HPV transmission and optimal control of cervical cancer in China. Sci Rep. 2025;15(1):21354. doi: 10.1038/s41598-025-05514-y

 

  1. Winer RL, Lin J, Anderson ML, et al. Strategies to Increase Cervical Cancer Screening With Mailed Human Papillomavirus Self-Sampling Kits: A Randomized Clinical Trial. JAMA. 2023;330(20):1971-1981. doi: 10.1001/jama.2023.21471

 

  1. Yin J, Zhang S, Wang S, et al. Age-specific clinical performance of HPV-based vs. cytology-based cervical cancer screening in China. Nat Commun. 2025;17(1):521. doi: 10.1038/s41467-025-67215-4

 

  1. Pillay J, Gates A, Guitard S, et al. Screening for the prevention and early detection of cervical cancer: systematic reviews to inform an update to recommendations by the Canadian Task Force on Preventive Health Care. Syst Rev. 2025;14(1):206. doi: 10.1186/s13643-025-02866-4

 

  1. Neibart SS, Smith TA, Fang JH, et al. Assessment of Cervical Cancer Prevention and Treatment Infrastructure in Belize. JCO Glob Oncol. 2021;7:1251-1259. doi: 10.1200/GO.21.00138

 

  1. Shao D, Wu P, Jiang H, Wang Z. Global trends and future projections of cervical cancer burden: an integrated analysis of GBD 2021, UN population and WHO HPV vaccination data. Front Public Health. 2026;14:1702186. doi: 10.3389/fpubh.2026.1702186

 

  1. Leeson S, Alalade R, Singh N, et al. Options for triage and implications for colposcopists within European HPV-based cervical screening programmes. Eur J Obstet Gynecol Reprod Biol. 2021;258:332-342. doi: 10.1016/j.ejogrb.2020.12.061

 

  1. Wang W, Sawleshwarkar S, Piraveenan M. Computational approaches of modelling human papillomavirus transmission and prevention strategies: a systematic review. J Biol Dyn. 2025;19(1):2436376. doi: 10.1080/17513758.2024.2436376

 

  1. Cuzick J, Adcock R, Kinney W, et al. Impact of HPV testing in opportunistic cervical screening: Support for primary HPV screening in the United States. Int J Cancer. 2023;153(1):83- 93. doi: 10.1002/ijc.34519

 

  1. Izadi-Najafabadi S, Smith LW, Gottschlich A, Booth A, Peacock S, Ogilvie GS. Cervical Cancer Screening Cascade: A framework for monitoring uptake and retention along the screening and treatment pathway. Curr Oncol. 2025;32(7):407. doi: 10.3390/curroncol32070407

 

  1. Curry SJ, Krist AH, Owens DK, et al. Screening for cervical cancer. JAMA. 2018;320(7):674-686. doi: 10.1001/jama.2018.10897

 

  1. Zhao F, Lang J, Qiao Y, Zhu L. How can China achieve WHO’s 2030 targets for eliminating cervical cancer? BMJ. 2024;386:e078641. doi: 10.1136/bmj-2023-078641

 

  1. Zhang M, Wang L, Zhang X, et al. Cervical Cancer Screening Rates Among Chinese Women - China, 2023-2024. China CDC Wkly. 2025;7(10):321-326. doi: 10.46234/ccdcw2025.052

 

  1. Dickson KS, Boateng ENK, Acquah E, Ayebeng C, Addo IY. Screening for cervical cancer among women in five countries in sub-Saharan Africa: analysis of the role played by distance to health facility and socio-demographic factors. BMC Health Serv Res. 2023;23(1):61. doi: 10.1186/s12913-023-09055-w

 

  1. Son Y, Hong S, Jang W, et al. Global, regional, and national burden of cervical cancer in 2022 and projections to 2050: a population-based analysis of GLOBOCAN. Int J Gynecol Cancer. 2026;36(1):102751. doi: 10.1016/j.ijgc.2025.102751

 

  1. Ma S, Sun K, Han B, Zheng R, Wei W. Cervical cancer burden and trends in China, 2000-2020: Asia-Pacific international comparisons and insights for elimination goals. Cancer Biol Med. 2025;22(9):1017-1035. doi: 10.20892/j.issn.2095-3941.2025.0386

 

  1. Shimels T, Kantelhardt EJ, Assefa M, Fenta TG. Spatiotemporal dynamics and prevention strategies of cervical cancer incidence in Addis Ababa, Ethiopia: an ecological study. BMJ Open. 2025;15(1):e089521. doi: 10.1136/bmjopen-2024-089521

 

  1. Garg P, Krishnamoorthy Y, Halder P, et al. Urban-rural disparities in cervical cancer screening among Indian women between 30-49 years: a geospatial and decomposition analysis using a nationally representative survey. BMC Cancer. 2025;25(1):67. doi: 10.1186/s12885-025-13446-z

 

  1. Canfell K, Kim JJ, Brisson M, et al. Mortality impact of achieving WHO cervical cancer elimination targets: a comparative modelling analysis in 78 low-income and lower-middle-income countries. Lancet. 2020;395(10224):591- 603. doi: 10.1016/S0140-6736(20)30157-4

 

  1. Pretsch PK, Spees LP, Brewer NT, et al. Effect of HPV self-collection kits on cervical cancer screening uptake among under-screened women from low-income US backgrounds (MBMT-3): a phase 3, open-label, randomised controlled trial. Lancet Public Health. 2023;8(6):e411-e421. doi: 10.1016/S2468-2667(23)00076-2

 

  1. Gomes M, Provaggi E, Pembe AB, Olaitan A, Gentry- Maharaj A. Advancing Cervical Cancer Prevention Equity: Innovations in Self-Sampling and Digital Health Technologies Across Healthcare Settings. Diagnostics. 2025;15(9):1176. doi: 10.3390/diagnostics15091176

 

  1. Bruni L, Serrano B, Roura E, et al. Cervical cancer screening programmes and age-specific coverage estimates for 202 countries and territories worldwide: a review and synthetic analysis. Lancet Glob Health. 2022;10(8):e1115-e1127. doi: 10.1016/S2214-109X(22)00241-8

 

  1. Sharma J, Yennapu M, Priyanka Y. Screening Guidelines and Programs for Cervical Cancer Control in Countries of Different Economic Groups: A Narrative Review. Cureus. 2023;15(6):e41098. doi: 10.7759/cureus.41098

 

  1. Baird S, Choonara S, Azzopardi PS, et al. A call to action: the second Lancet Commission on adolescent health and wellbeing. Lancet. 2025;405(10493):1945-2022. doi: 10.1016/S0140-6736(25)00503-3

 

  1. Zhu J, Ge Z, Xia J, Liu Q, Ran Q, Yang Y. Status quo and problem analysis of cervical cancer screening program in China: Based on RE-AIM framework. Front Public Health. 2022;10:987787. doi: 10.3389/fpubh.2022.987787
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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