Trend in Cervical Cancer Incidence and Mortality Rates in China, 2006-2030: A Bayesian Age-Period-Cohort Modeling Study

Background: There are no studies extrapolating the incidence and mortality of cervical cancer in China by comparing incidence and deaths pattern between geographic and age groups.Methods: We applied age-period-cohort models to assess region -level trends in incidence and mortality from 2006 to 2016, with piecewise linear regression in a Bayesian framework to predict these trends to 2030.Results: Between 2006 and 2016, age-standardized incidence rates (ASIR) for females aged 15 to 84 years increased by 3.7% (95% confidence interval, 3.1%-4.3%) annually from 11.01 to 16.41 per 100,000 females in China. In the 25 to 39 age groups, the incidence rates decreased in urban regions and inversely increased in rural regions. The age-standardized mortality rates (ASMR) increased from 3.18 to 4.83, with annual increases of about 3.6% (1.5%-5.8%). From 2017 to 2030, the ASIR is expected to increase from 17.13 (15.91-18.46) to 23.22 (20.02-27.01) by 2.5% per year (P < 0.05). Meanwhile, the average age at diagnosis is predicted to grow from 53.1 to 60.5 years. In the 15 to 54 age groups, the incidence rates decreased in urban regions but increased in rural regions. The ASMR is expected to increase consistently from 4.82 (4.38-5.31) to 9.13 (7.35-11.39) by 5.0% per year (P < 0.05).Conclusions: Cervical cancer incidence and mortality rates are projected to increase in China. In addition, the urban-rural inci-dence gap is estimated to widen further among young women. Impact: Cervical cancer prevention should consider the trend and diversity in incidence patterns between urban and rural regions.