中国目前接种人乳头瘤病毒（HPV）疫苗和进行筛查的情况远远低于世界卫生组织（WHO）2030年消除宫颈癌的目标。我们量化了在中国延误大规模HPV疫苗接种和筛查实施所带来的卫生和经济损失。我们使用了一个先前验证过的传播模型来预测终身的健康效益、费用、效果和消除宫颈癌的时间表，包括从2022年到2030年不同筛查模式和覆盖率提高速度下的HPV疫苗接种组合以及单独筛查。考虑在2022年至2100年间居住或预计出生于中国的所有妇女。我们采用了一个社会角度的视角。无论疫苗类型如何，从2022年开始立即进行大规模接种，并在2030年实现基于HPV的筛查覆盖率达到70％（无延误情景）将是最低成本和最有效的方案。与无延误情景相比，将接种推迟八年将导致增加434,000-543,000例宫颈癌病例，138,000-178,000例死亡，并产生2863-4437百万美元的费用，延误消除事业9-10年。即使立即接种疫苗，根据目前的缓慢推广情况，到2070年将有2,530,000-3,060,000额外的病例，909,000-1,040,000人死亡，并产生5098-5714百万美元的费用，与无延误情景相比，而且如果使用国产的2价或4价HPV疫苗则无法实现消除（在2100年每10万妇女的患病率为4.09-4.21例）。推迟大规模HPV疫苗接种和/或高效筛查实施会对宫颈癌发病率、死亡率和开支产生不利影响。这些发现应促使卫生部门加快大规模疫苗接种和筛查改进。本研究得到了比尔和梅琳达·盖茨基金会（INV-031449和INV-003174）以及中国医学科学院医学创新基金（CIFMS）（2021-I2M-1-004）的支持。© 2023作者。

Current uptake of HPV vaccination and screening in China is far below World Health Organization 2030 targets for cervical cancer elimination. We quantified health and economic losses of delaying large-scale HPV vaccination and screening implementation in China.We used a previously validated transmission model to project lifetime health benefits, costs, effectiveness, and timeline for cervical cancer elimination of alternative scenarios, including combining HPV vaccination initiated from 2022 to 2030 with screening in different modalities and coverage increase rates, as well as screening alone. All women living or projected to be born in China during 2022-2100 were considered. We employed a societal perspective.Regardless of vaccine type, immediate large-scale vaccination initiated in 2022 and achieving 70% coverage of HPV-based screening in 2030 (no-delay scenario) would be the least costly and most effective. Compared with the no-delay scenario, delaying vaccination by eight years would result in 434,000-543,000 additional cervical cancer cases, 138,000-178,000 deaths, and $2863-4437 million costs, and delay elimination by 9-10 years. Even with immediate vaccination, the gradual scale-up of LBC-based screening to 70% coverage in 2070 would result in 2,530,000-3,060,000 additional cases, 909,000-1,040,000 deaths, and $5098-5714 million costs compared with no-delay scenario, and could not achieve elimination if domestic 2vHPV or 4vHPV vaccines are used (4.09-4.21 cases per 100,000 woman in 2100).Delaying large-scale HPV vaccination and/or high-performance screening implementation has detrimental consequences for cervical cancer morbidity, mortality, and expenditure. These findings should spur health authorities to expedite large-scale vaccine rollout and improve screening.Bill & Melinda Gates Foundation (INV-031449 and INV-003174) and CAMS Innovation Fund for Medical Sciences (CIFMS) (2021-I2M-1-004).© 2023 The Authors.