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中国的人乳头瘤病毒传播与宫颈癌的最佳防控

HPV transmission and optimal control of cervical cancer in China.

作者信息

Ren Huarong, Xu Rui, Zhang Juan

机构信息

Complex Systems Research Center, Shanxi University, Taiyuan, 030006, Shanxi, People's Republic of China.

Complex Systems and Data Science Key Laboratory of Ministry of Education, Taiyuan, 030006, Shanxi, People's Republic of China.

出版信息

Sci Rep. 2025 Jul 1;15(1):21354. doi: 10.1038/s41598-025-05514-y.

DOI:10.1038/s41598-025-05514-y
PMID:40594174
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12218410/
Abstract

Cervical cancer (CC), the fourth most common female malignancy globally, is predominantly caused by persistent infection with high-risk human papillomavirus (HPV) strains. China faces a particularly severe burden, exhibiting both the world's second-highest CC prevalence and an alarming epidemiological trend characterized by steadily increasing incidence rates and younger age of onset. In response to the WHO's global elimination strategy, China launched the Action Plan for Accelerated Elimination of Cervical Cancer (2023-2030). Aligned with national prevention and control objectives, considering two key interventions, that is widespread HPV vaccination and systematic CC screening, this study develops a novel two-sex, age-structured transmission model to characterize HPV transmission dynamics and CC progression, and implementation of intervention strategies. Through mathematical modeling analysis and simulation, we quantify age- and sex-specific risk profiles, predict long-term epidemiological trends. Using optimal control theory, we propose a supply-constrained vaccine allocation strategy for maximal population protection and a cost-effective screening implementation plan, which will provide evidence-based recommendations to support China's national CC elimination goals.

摘要

宫颈癌（CC）是全球第四大常见女性恶性肿瘤，主要由高危型人乳头瘤病毒（HPV）毒株的持续感染引起。中国面临着尤为严峻的负担，其CC患病率位居世界第二，且呈现出令人担忧的流行病学趋势，即发病率稳步上升且发病年龄趋于年轻化。为响应世界卫生组织的全球消除战略，中国启动了《加速消除宫颈癌行动计划（2023-2030年）》。本研究结合国家防控目标，考虑广泛的HPV疫苗接种和系统性CC筛查这两项关键干预措施，构建了一个新颖的两性、年龄结构化传播模型，以描述HPV传播动态和CC进展情况以及干预策略的实施情况。通过数学建模分析和模拟，我们量化了特定年龄和性别的风险特征，预测了长期流行病学趋势。运用最优控制理论，我们提出了一种供应受限的疫苗分配策略以实现最大程度的人群保护以及一项具有成本效益的筛查实施方案，这将为支持中国国家CC消除目标提供基于证据的建议。

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