The year 2025 witnessed milestone advancements in the field of cervical cancer prevention and treatment in China. Breakthroughs have been achieved across key aspects including vaccination, screening and diagnosis, and clinical treatment, laying a solid foundation for the ultimate realization of the global goal of cervical cancer elimination. As the year draws to a close, the Gynecology and Obstetrics Network invited Professor Wei Lihui from Peking University People's Hospital to provide a systematic review and in-depth analysis of the year's progress and future directions.
I. Core Annual Summary: Coordinated Advancement in Vaccination, Screening, and Treatment
PART 01 HPV Vaccines: Expanding Vaccine Varieties, Precisely Optimizing Target Groups and Schedules
In 2025, China achieved a major breakthrough in the availability of prophylactic HPV vaccines. With the approval of the National Medical Products Administration (NMPA), the number of available vaccines reached seven, forming a comprehensive vaccine supply system. This includes three bivalent vaccines (two domestic), two quadrivalent vaccines (one domestic), and two nonavalent vaccines (one domestic), meeting the prevention needs for different valencies. Regarding applicable age ranges, aside from the newly approved Hansenuladerived quadrivalent vaccine for ages 18-45 and the Pichiaderived bivalent vaccine for ages 9-30, the other five vaccines all cover individuals aged 9-45. Currently, the domestic bivalent HPV vaccine (E. coli) has received WHO prequalification. This year also saw the standardized promotion of male vaccination for the first time—the imported quadrivalent vaccine is indicated for males aged 9-26, and the imported nonavalent vaccine for males aged 16-26—filling a gap in male HPV prevention.
Notably, vaccination schedules have been further optimized. For girls aged 9-14, most vaccines now require only 2 doses. The domestic E. colinonavalent vaccine has even extended the 2-dose schedule to girls aged 9-17, significantly lowering the threshold and cost of vaccination, creating favorable conditions for widespread vaccination among adolescents. For China, with its large population base and relatively high cervical cancer incidence, the rich variety of vaccines and flexible dosing regimens provide a robust guarantee for national HPV prevention and control.
PART 02 Screening Technology: Genotyping Takes the Lead, Diversified Triage System Upgraded
In the realm of screening technology, China has fully entered the era of "precision." Due to its higher sensitivity, HPV testing has become the preferred primary screening method in areas with adequate conditions, effectively reducing missed diagnoses of high-grade lesions. Currently, clinically applied HPV testing technologies have been upgraded to genotyping, enabling precise identification of high-risk subtypes like HPV 16 and 18. Test kits for both HPV DNA and HPV mRNA are available, offering more technical choices for screening.
Innovative breakthroughs in triage technology emerged as a highlight of the year, keeping pace with international advancements. In addition to traditional cytology triage, internationally advanced techniques such as dual-stain cytology for P16/Ki-67 and epigenetic methylation assays are now widely used. The integrated triage method independently developed by the team led by Academician Martin Ding represents a breakthrough of the "Chinese Solution." Furthermore, multiple triage methods, including extended HPV genotyping and HPV viral load testing, are used in parallel. Clinics can flexibly choose based on regional economic levels and hospital technical capabilities, significantly improving the precision of triaging HPV primary screening positive individuals and avoiding risks of overtreatment or underdiagnosis.
PART 03 Treatment Philosophy: Individualized Stratified Treatment, Innovation in Conservative Therapies
In 2025, the treatment philosophy for cervical intraepithelial neoplasia (CIN) underwent a significant shift, moving away from the traditional "one-size-fits-all" approach. The management of CIN II lesions, in particular, emphasizes the core principles of "refined stratification + individualized treatment." Due to the significant heterogeneity of CIN II lesions (some cases are not true precancerous lesions), clinical risk stratification is performed via screening, colposcopy, and pathological examination. High-risk cases receive excisional treatments like LEEP or conization, while low-risk cases, especially in young women with fertility desires, are managed with conservative approaches, aligning with China's goal of building a fertility-friendly society.
Advancements in conservative treatment technologies provide more options for individualized management. Ablative techniques like laser, cryotherapy, and infrared coagulation are becoming increasingly mature. Photodynamic therapy (PDT), an emerging treatment, has shown promising clinical results by precisely targeting abnormal cells through the synergistic action of photosensitizers and specific light wavelengths. For CIN III lesions, surgical treatment remains primary. However, under strict triage and clear diagnosis, selective ablation or PDT may be cautiously considered for a small subset of patients—specifically excluding invasive carcinoma and adenocarcinoma, with type 1 transformation zone on colposcopy, and strong fertility desires—but strict control of indications is mandatory to avoid missed diagnosis or inadequate treatment.
II. Individualized Clinical Management Plans: Multidimensional Precision Considerations, Balancing Efficacy and Quality of Life
Formulating individualized clinical management plans for cervical cancer-related lesions requires integrating multiple core factors based on standardized principles to achieve a balance between efficacy, safety, and patient quality of life.
PART 01 Core Prerequisite: Precise Diagnosis Defining the Nature of the Lesion
Accurately distinguishing the nature and degree of the lesion is the foundation of individualized treatment. This relies on experienced clinicians, precise screening techniques, standardized colposcopy, and the gold standard of pathology to clarify whether the patient has a low-grade lesion, a high-grade lesion, or carries a risk of invasive carcinoma or adenocarcinoma, thereby avoiding overtreatment or undertreatment.
PART 02 Key Consideration: Aligning with Patient Age and Fertility Desires
With the advancement of China's fertility-friendly society construction, fertility desires are no longer limited to young women. The proportion of patients under 40 seeking fertility preservation has risen significantly. Clinical decisions must fully consider this need, prioritizing conservative or minimally invasive treatments for eligible patients to preserve reproductive function as much as possible. For middle-aged and elderly patients without fertility desires, more definitive treatment options can be chosen based on risk assessment to reduce recurrence risk.
PART 03 Critical References: Precise Assessment of Risk Stratification and Lesion Characteristics
Comprehensively assess the patient's risk level through screening results, lesion extent on colposcopy, and pathological diagnosis. Special attention should be paid to endocervical involvement—conservative treatment carries higher risks for such lesions due to their hidden location, and this must be a key consideration in planning. Additionally, the presence of high-risk factors like invasive carcinoma or adenocarcinoma directly influences treatment choice.
III. Implementation of the National Immunization Program: Universalizing HPV Vaccination, Advancing Cervical Cancer Elimination Goals
On November 10, 2025, the State Council, in conjunction with seven ministries, issued a policy integrating the HPV vaccine into the National Immunization Program (NIP) for 13-year-old girls, providing two free doses of the bivalent HPV vaccine. This is a pivotal milestone in China's cervical cancer prevention history, marking a crucial step from "voluntary and self-paid" to "universal and accessible" HPV vaccination.
PART 01 Policy Implementation: Evidence-Based and Scientific Decision-Making
Previously, various provinces and cities in China had piloted diverse vaccination models—fully free, partially subsidized, and fully self-paid—based on economic levels. Vaccination in younger age groups was also promoted in some regions, accumulating substantial empirical data for national policymaking. Selecting 13-year-old girls as the core NIP target aligns with the scientific consensus that vaccination is most effective at ages 9-14. It also considers China's education system, as girls in the first and second years of junior high school can complete vaccination during summer/winter vacations without exam pressure, ensuring high practical feasibility.
PART 02 Prevention Value: Vaccination at Young Age Highlights Long-Term Efficacy
International experience shows that promoting HPV vaccination among females aged 9-14 can reduce cervical cancer incidence in adulthood by 85%-88%, far exceeding the effect in older age groups. China's current cervical cancer incidence is about 13 per 100,000, while the international standard for elimination is less than 4 per 100,000. Achieving a vaccination coverage rate of over 70% among 13-year-old girls is expected, through long-term follow-up, to lead to a significant decline in cervical cancer incidence, bringing China closer to its strategic goal of elimination.
PART 03 Future Direction: Coordinated Advancement Across the Entire Chain
In the future, while advancing the NIP implementation, it is essential to continuously expand vaccine supply, optimize vaccination services, strengthen public health education, and improve awareness and acceptance of HPV vaccination across all age groups. Simultaneously, the three-tier cervical cancer prevention system must be further refined, promoting continuous innovation and dissemination of screening, diagnosis, and treatment technologies to form a comprehensive "Prevention – Screening – Treatment" prevention and control framework.
Summary
In 2025, China's cervical cancer prevention and treatment field achieved comprehensive breakthroughs in vaccination, screening, and treatment. The implementation of the National Immunization Program has opened a new chapter in national prevention and control. With the deepening advancement of policies and continuous technological iteration, China is poised to gradually reduce cervical cancer incidence, steadily progress towards the goal of elimination, and safeguard the health of women.
Expert Profile
Wei Lihui, M.D., Professor
Peking University People's Hospital
Professor, Chief Physician, and Doctoral Supervisor in the Department of Obstetrics and Gynecology, Peking University People's Hospital. Recipient of the State Council Special Allowance.
❖ Professional Appointments: Honorary Director of the Department of Obstetrics and Gynecology, Peking University; Chair of the Chinese Society for the Study of Vaginal Diseases and Cervical Pathology, China Healthy Birth Science Association; Member of the International Federation of Cervical Pathology and Colposcopy (IFCPC); Member of the American Society for Colposcopy and Cervical Pathology (ASCCP); Deputy Editor-in-Chief of the Chinese Journal of Obstetrics and Gynecology; Editor-in-Chief of the Chinese Journal of Clinical Obstetrics and Gynecology.
❖ Academic Contributions: Has made significant contributions to advancing medical care, scientific research, and education in obstetrics and gynecology in China, with extensive research and practical experience especially in the prevention and control of cervical cancer. Has released a thematic video on this topic on the People's Daily Health Client's "Two Sessions Health Policy" livestream program. Served as Director of the Department of Obstetrics and Gynecology at Peking University People's Hospital for many years, took the lead in establishing the Department of Obstetrics and Gynecology at Peking University, forming the disciplinary strengths of Peking University in this field. In recent years, has promoted China's cervical cancer prevention and control work onto the global stage.
❖ Honors and Achievements: Recipient of numerous first, second, and third prizes for scientific and technological progress from the Ministry of Education, Chinese Medical Association, Chinese Preventive Medicine Association, and Beijing Municipality; recipient of the Chinese Physician Award; has published over 400 research papers; authored multiple professional textbooks; has supervised 76 Master's, PhD, and postdoctoral students.
Editor: Lily