{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T06:02:40Z","timestamp":1784872960709,"version":"3.55.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Purpose<\/jats:title>\n To assess COVID-19\u2019s impact on global cervical cancer burden and examine how COVID-19 vaccination rates and Human Development Index (HDI) interact to shape disease trends, with exploratory projections to 2050.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Using Global Burden of Disease 2023 data (1990\u20132023), we analyzed age-standardized incidence (ASIR) and disability-adjusted life-year (DALY) rate of cervical cancer. Joinpoint regression estimated annual percentage changes (EAPC) for pre-pandemic (1990\u20132019) and pandemic (2020\u20132023) periods. Linear and interaction models assessed associations between HDI, COVID-19 vaccination rates, and EAPC, with bidirectional stratified analyses. Projections to 2050 were generated under three exploratory scenarios.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The pandemic coincided with a reversal of the pre-pandemic declining trend in cervical cancer burden indicators. Global ASIR increased 6.0% (\n p<\/jats:italic>\n \u202f=\u202f0.031), with EAPC shifting from \u22120.41%\/year (\n p<\/jats:italic>\n \u202f&lt;\u202f0.001) to 3.93%\/year (\n p<\/jats:italic>\n \u202f=\u202f0.008). Low-SDI regions experienced the sharpest rise (ASIR 18.6%). EAPC showed a significant negative association with HDI (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u221215.4,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). The interaction term was positive (\n \u03b2<\/jats:italic>\n \u202f=\u202f36.1,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001, \u0394\n R<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f6.4%). Bidirectional stratification revealed divergent patterns. In low-HDI countries, higher vaccination coincided with lower EAPC (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22127.15,\n p<\/jats:italic>\n \u202f=\u202f0.005). In high-HDI countries, a positive association emerged (\n \u03b2<\/jats:italic>\n \u202f=\u202f6.53,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). HDI effects attenuated across vaccination quartiles: strong negative associations in low-vaccination contexts (Q1:\n \u03b2<\/jats:italic>\n \u202f=\u202f\u221229.06, R\n 2<\/jats:sup>\n \u202f=\u202f39.7%) to non-significance in high-vaccination settings (Q4:\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22124.97,\n p<\/jats:italic>\n \u202f=\u202f0.244). Under current trends, low-SDI regions would achieve WHO 90\u201370-90 targets ~10\u201312\u202fyears behind high-SDI regions.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n COVID-19 vaccination rate shows context-dependent associations with cervical cancer burden: stronger negative associations in low-HDI settings and positive associations in high-HDI settings. These findings support dual-purpose investments in emergency infrastructure for pandemic preparedness and cancer control.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1858206","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:34:50Z","timestamp":1784871290000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["COVID-19 vaccination rates as a proxy for health system resilience: implications of development disparities for cervical cancer control during the pandemic"],"prefix":"10.3389","volume":"13","author":[{"given":"Qian","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, the First Affiliated Hospital of Air Force Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Xi\u2019an Electric Power Central Hospital","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, the First Affiliated Hospital of Air Force Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlei","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, the First Affiliated Hospital of Air Force Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1946","DOI":"10.1136\/ijgc-2024-005579","article-title":"Cervical cancer: a new era","volume":"34","author":"Caruso","year":"2024","journal-title":"Int J 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