Objective Colorectal cancer (CRC) screening has been widely implemented in many countries. However, evidence on participation and diagnostic yield of population-based CRC screening in China is sparse. Design The analyses were conducted in the context of the Cancer Screening Program in Urban China, which recruited 1 381 561 eligible participants aged 40–69 years from 16 provinces in China from 2012 to 2015. 182 927 participants were evaluated to be high risk for CRC by an established risk score system and were subsequently recommended for colonoscopy. Participation rates and detection of colorectal neoplasms in this programme were reported and their associated factors were explored. Results 25 593 participants undertook colonoscopy as recommended, with participation rate of 14.0%. High level of education, history of faecal occult blood test, family history of CRC and history of colonic polyp were found to be associated with the participation in colonoscopy screening. Overall, 65 CRC (0.25%), 785 advanced adenomas (3.07%), 2091 non-advanced adenomas (8.17%) and 1107 hyperplastic polyps (4.33%) were detected. Detection rates of colorectal neoplasms increased with age and were higher for men. More advanced neoplasms were diagnosed in the distal colon/rectum (65.2%). Several factors including age, sex, family history of CRC, dietary intake of processed meat and smoking were identified to be associated with the presence of colorectal neoplasms. Conclusion The diagnostic yield was not optimal using colonoscopy screening in high-risk populations given the relatively low participation rate. Our findings will provide important references for designing effective population-based CRC screening strategies in the future.

Many countries have included the human papillomavirus (HPV) vaccine in their national immunization programs. However, comprehensive studies on global HPV vaccination coverage remain scarce. This study aims to provide an in-depth overview of the current status of global HPV immunization programs and assess HPV vaccination coverage worldwide. In this study, we performed a comprehensive search of the PubMed and Embase databases (from their inception to February 28, 2025), websites, the WHO database, to identify HPV vaccination policies and coverage rate data from all 194 WHO member states. Studies included in our analysis reported population-based HPV vaccination coverage rates. Additionally, we analyzed trends in HPV vaccination coverage from 2010 to 2023 and evaluated cervical cancer incidence rates during the same period in 15 early-adopter countries of HPV vaccines. Subgroup analyses were conducted by sex and age. The systematic review was prospectively registered in PROSPERO (registration number: CRD42023488463). As of February 28, 2025, 148 WHO member states have incorporated the HPV vaccine into their national immunization programs. 132 countries reported HPV vaccination coverage estimates for the first dose and 129 countries reported full doses in 2023, and the weighted average coverage of the first and full dose of HPV vaccination in girls aged 9–14 years were 61.6% (95% CI: 50.9%–71.8%) and 47.6% (39.7%–57.4%) respectively. Among 132 countries, fifteen countries (11%) achieved 90% coverage for the first dose. Upper-middle income countries presented the highest coverage, with 71.7% (95% CI: 59.1%–78.6%) for the first dose. Age-specific analysis revealed that vaccination coverage of China peaked in women in 20–24 age group and was lowest in 9–14. Time trend analysis demonstrated that in most assessed countries, cervical cancer incidence is showing a declining trend. Global HPV vaccination coverage remains significantly below the target of 90%. Strategies to effectively enhance HPV vaccination coverage must be identified, developed, and implemented to address this gap. CAMS Innovation Fund for Medical Sciences (2021-I2M-1–004, 2023-I2M-3-019); National High Level Hospital Clinical Research Funding (2022-PUMCH-D-003); Supported by 10.13039/501100012151 Sanming Project of Medicine in Shenzhen (SZSM202311011).

Epstein-Barr virus (EBV) infection is found in a subset of gastric cancers. Previous reviews have exclusively focused on EBV-encoded small RNA (EBER) positivity in gastric cancer tissues, but a comprehensive evaluation of other type of studies is lacking.We searched the PubMed database up to September, 2014, and performed a systematic review.We considered studies comparing EBV nucleic acids positivity in gastric cancer tissue with positivity in either adjacent non-tumor tissue of cancer patients or non-tumor mucosa from healthy individuals, patients with benign gastric diseases, or deceased individuals. We also considered studies comparing EBV antibodies in serum from cancer patients and healthy controls.Selection of potentially eligible studies and data extraction were performed by 2 independent reviewers. Due to the heterogeneity of studies, we did not perform formal meta-analysis.Forty-seven studies (8069 cases and 1840 controls) were identified. EBER positivity determined by in situ hybridization (ISH) was significantly higher in cancer tissues (range 5.0%-17.9%) than in adjacent mucosa from the same patients or biopsies from all control groups (almost 0%). High EBV nuclear antigen-1 (EBNA-1) positivity by PCR was found in gastric cancer tissues, but most were not validated by ISH or adjusted for inflammatory severity and lymphocyte infiltration. Only 4 studies tested for EBV antibodies, with large variation in the seropositivities of different antibodies in both cases and controls, and did not find an association between EBV seropositivity and gastric cancer.In summary, tissue-based ISH methods strongly suggest an association between EBV infection and gastric cancer, but PCR method alone is invalid to confirm such association. Very limited evidence from serological studies and the lack of novel antibodies warrant further investigations to identify potential risk factors of EBV for gastric cancer.