HPV transmission and optimal control of cervical cancer in China.

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.