Objective  To examine the disease burden of cervical cancer in 127 countries along the Belt and Road.

  Methods  The 127 countries involved in the analysis were determined based on the information from the website of China's Belt and Road Initiative and the countries were assigned into one of the 6 World Health Organization (WHO) regions. The country-specific data of 2018 on world population based age standardized incidence and mortality rate and disability-adjusted life years (DALYs) of cervical cancer were extracted from WHO cancer registry database for analyzing and comparing between country disparities in disease burden of cervical cancer using descriptive statistics. Cluster analysis was used to assess prevalence intensity of cervical cancer among the countries in different WHO regions.

  Results  The disease burden of cervical cancer in 2018 was significantly different among the 127 countries in various WHO regions along the Belt and Road. The mean age-standardized incidence rate (32.4/100 000) and mortality rate (21.9/100 000) of cervical cancer were the highest for the countries in the WHO African region; while, those for the countries in the WHO Mediterranean region were the lowest (age-standardized incidence and mortality rate: 4.4/100 000 and 2.9/100 000). The mean DALYs of cervical cancer was the highest (458.2/100 000) for the countries in the WHO region of America but the lowest (69 /100 000) for countries in the WHO Eastern Mediterranean region. The results of cluster analysis showed that the prevalence of cervical cancer was at medium-high level for countries in WHO African region and at low level for countries in the WHO European, Western Pacific and Eastern Mediterranean regions.

  Conclusion   Geographical region is the main, but not the only factor affecting the disease burden of cervical cancer for countries along the Belt and Road and the influences of country-specific social and economic development, natural and social environment should be considered in cervical cancer control.