基于地理加权回归模型的中国适龄人群人乳头瘤病毒疫苗覆盖率及影响因素研究
The HPV Vaccine Coverage and Its Influencing Factors among the Eligible Population in China Based on a Geographically Weighted Regression Model
罗煜橦 1李静1
作者信息
- 1. 610041 四川省成都市，四川大学华西公共卫生学院 / 四川大学华西第四医院流行病与卫生统计学系
- 折叠
摘要
背景 宫颈癌是全球女性第四大常见恶性肿瘤，高危型人乳头瘤病毒（HR-HPV）持续感染是其必要病因。HPV疫苗接种可有效预防宫颈癌，但我国HPV疫苗覆盖率远低于WHO提出的90%的目标。目前，关于影响HPV疫苗覆盖率的因素研究不足，本研究可以为该领域研究积累证据。目的 探讨中国适龄人群HPV疫苗覆盖率及影响因素的空间关系，为不同省级行政区域制订符合各地区实际情况的HPV疫苗接种策略提供科学依据。方法 本研究的因变量为2022年中国各省级行政区HPV疫苗覆盖率，来源于中国疾病预防控制中心发布的数据；自变量涵盖社会经济水平与卫生指标两大类共10个变量［女性初中教育率、女性高中教育率、女性高等教育率、女性文盲率、女性就业率、女性少数民族人口比例、女性乡村人口比例、人均可支配收入、人均医疗保健支出、社区卫生服务中心（站）数］，来源于第七次全国人口普查、《中国统计年鉴2022》、国家统计局发布的相关数据。使用R 4.1.3软件进行数据处理和一般分析，并构建线性回归模型，使用Arc GIS 10.8软件进行全局空间自相关分析、构建地理加权回归模型及热点分析，并绘制空间分布图。本研究的数据收集与分析工作于2025年4月完成。结果 全国各省级行政区的HPV疫苗覆盖率为2.55%~25.4%，不同省级行政区的HPV疫苗覆盖率存在差异，并呈现出明显的空间集聚特征（Moran's I 指数为0.198，P=0.007），东南地区和川渝地区覆盖率较高，西部地区覆盖率相对较低。HPV疫苗覆盖率受女性受教育水平、经济水平、女性社会人口学特征、社区卫生服务中心（站）数的影响（P<0.05），且影响程度存在的空间差异。结论 中国HPV疫苗覆盖率呈东南高、西北低的现象，女性高等教育率、人均可支配收入和女性乡村人口比例是空间差异的核心原因。政府部门可以在西部地区实行“中央全额买单、流动接种和健康教育宣传”的三重政策；东部地区为弱势人群提供经济支持；中部地区扩大HPV疫苗接种优惠政策的适用人群并通过行为激励将高知识水平转化为高接种率，以精准化、地方化的策略提升HPV疫苗覆盖率，实质性推进宫颈癌消除。
Abstract
Background Cervical cancer is the fourth most common malignant tumor among women worldwide, with persistent infection of high-risk human papillomavirus (HR-HPV) being its necessary cause. HPV vaccination can effectively prevent cervical cancer; however, the coverage rate of HPV vaccination in China remains far below the 90% target set by the WHO. Current research on factors influencing HPV vaccine coverage is insufficient. This study aims to contribute evidence to this field. Objective To explore the spatial relationships between HPV vaccine coverage and its influencing factors among the eligible population in China, and to provide a scientific basis for formulating region-specific HPV vaccination strategies tailored to the actual conditions of different provincial-level administrative regions. Methods The dependent variable was derived from the 2022 regional statistics on HPV vaccine coverage released by the Chinese Center for Disease Control and Prevention. Independent variables were obtained from the Seventh National Population Census, the China Statistical Yearbook 2022, and the National Bureau of Statistics, covering 10 continuous variables across two categories: socioeconomic level and health indicators. These included female junior high school, senior high school, and higher education rates; female illiteracy rate; female employment rate; proportion of ethnic minority women; proportion of rural women; per capita disposable income; per capita healthcare expenditure; and number of community health service centers (stations). All variables were included in the model in their original form. Data processing and general analysis were performed using R software, and a linear regression model was constructed. Global spatial autocorrelation analysis, geographically weighted regression (GWR) modeling, and hotspot analysis were conducted using ArcGIS software, with spatial distribution maps generated. Data collection and analysis were completed in April 2025. Results The HPV vaccine coverage rates across provinces ranged from 2.55% to 25.4%. Significant differences in coverage were observed among provincial-level administrative regions, exhibiting distinct spatial clustering characteristics (Moran's I index=0.198, P=0.007). Coverage was higher in southeastern regions and the Sichuan-Chongqing area, while relatively lower in western regions. HPV vaccine coverage was influenced by female education level, economic status, female sociodemographic characteristics, and the number of community health service centers (stations) (P<0.05), with varying degrees of impact across spaces. Conclusion HPV vaccine coverage in China demonstrates a pattern of higher rates in the southeast and lower rates in the northwest. Female higher education rate, per capita disposable income, and proportion of rural women are core factors contributing to this spatial disparity. A triple policy of "central government full funding, mobile vaccination units, and health education campaigns" could be implemented in western regions. Eastern regions should provide economic support for disadvantaged populations. Central regions could expand the eligibility for HPV vaccination subsidies and convert high health literacy into higher vaccination rates through behavioral incentives. Adopting precise, localized strategies will enhance HPV vaccine coverage and substantially advance the elimination of cervical cancer.关键词
乳头状瘤病毒疫苗/疫苗接种覆盖率/地理加权回归模型/社会经济因素/影响因素分析引用本文复制引用
罗煜橦,李静.基于地理加权回归模型的中国适龄人群人乳头瘤病毒疫苗覆盖率及影响因素研究[EB/OL].(2026-03-19)[2026-03-21].https://chinaxiv.org/abs/202603.00104.学科分类
预防医学/医学研究方法
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