Assessment of Factors and Trends Affecting Different Pathological Types of Cervical Cancer in China From 2013 to 2022
Yufei Li, Runhua Li, Rufei Duan, Xiaofen Gu, Jia You, Hong Wang, Tingting Zuo, Zhe Wang, Weizhao Lin, Li Li, Bo Zhu, Shaokai Zhang, Wen Yang, Shuai Yuan, Hongping Zhang, Lingbin Du, Jian Yin, Huan Yang, Youlin QiaoABSTRACT
Objective
Cervical cancer poses a significant burden globally, particularly in developing countries, with China accounting for 20% of the global incidence. This study aimed to examine temporal changes in the pathological distribution of cervical cancer, particularly squamous cell carcinoma (SCC) and adenocarcinoma (ADC), in China from 2013 to 2022.
Methods
A nationwide, multicenter, retrospective study analyzed 6645 cervical cancer cases diagnosed between 2013 and 2022 across seven tertiary hospitals in China. The study analyzed demographic, obstetric, and reproductive factors to identify trends in the proportions of SCC and ADC. Multivariable logistic regression was further performed among women with SCC or ADC to identify factors independently associated with histological type.
Results
SCC accounted for 86.9% and ADC for 10.4% of invasive cervical cancer (ICC) cases. Although no significant change in SCC proportion was observed overall, declines were observed in specific subgroups—unemployed women, premenopausal women, and those with a history of reproductive system disease ( p trend = 0.012, 0.021, and 0.011, respectively). In multivariable analysis, compared with Central China, the odds of ADC relative to SCC were significantly higher in North China, Southwest China, East China, and South China, whereas menopausal women, Uyghur women, and rural residents showed lower odds of ADC relative to SCC.
Conclusions
Although the overall proportion of SCC among ICC cases remained statistically stable during 2013–2022, SCC showed a decreasing trend in several high‐risk subpopulations. Compared with our 2005–2010 series, the present 2013–2022 study showed a higher ADC proportion and a lower SCC proportion. These findings suggest a gradual shift in the pathological landscape of ICC in China and provide up‐to‐date nationwide multicenter data that may help refine future screening and prevention strategies.