Background: Cervical cancer remains a substantial public health burden in China. The historic integration of HPV vaccination into the NIP in 2025 represents a major advance in primary prevention. However, its nationwide scale-up faces significant challenges, including ensuring equitable access, managing vaccine confidence, securing sustainable financing, and effectively integrating this initiative into existing health systems. Concurrently, achieving national elimination targets requires the parallel scale-up of equitable, high-quality secondary prevention through screening. Current screening efforts are hindered by fragmented follow-up pathways, variable service quality, and suboptimal coverage, particularly among older and underserved women. The success of the elimination strategy now critically depends on shifting from policy adoption to the integrated, synergistic nationwide implementation of this dual-pillar approach.

Objective: This analysis aims to identify key implementation challenges following policy adoption and propose an evidence-based, coordinated framework to scale up both HPV vaccination and cervical cancer screening in China.

Methods: We conducted a narrative synthesis of national policy documents, epidemiological data, program implementation evaluation reports, relevant academic literature, and insights from China's policy evolution pathway. A comprehensive analysis of this evidence base identifies core bottlenecks on both the supply and demand sides. An integrated intervention strategy is then constructed, drawing on global lessons and China's specific context.

Key Findings: 
The successful scale-up hinges on four interdependent pillars:
Policy and Financing Coordination: While central funding for vaccine procurement is secured, sustainable financing for vaccination service delivery and for scaling up high-quality screening remains a challenge. Innovative fiscal mechanisms are promoted to ensure equitable implementation across regions and to support the screen-diagnose-treat continuum.
Integrated Service Delivery: Beyond institutionalizing school-based vaccination, systems must reach out-of-school adolescents and integrate screening services. A primary HPV testing strategy will be further promoted within strengthened primary healthcare. Crucially, a national digital health information system is required to track vaccination status, screening results, and treatment follow-up, enabling life-long prevention management.
Monitoring Impact and Building Evidence: Robust surveillance is essential to monitor program performance and impact. We will conduct the CHRONOS-CN study to generate essential real-world evidence on vaccine effectiveness in domestic low-resource settings. In parallel, surveillance systems to monitor key screening indicators—such as the stage distribution of CIN and cervical cancer at diagnosis and trends in incidence and mortality—will be further designed to directly evaluate and iteratively improve screening effectiveness.
Model-Informed Strategy Transition: We propose to leverage economic and epidemiological modelling as a core tool for strategic foresight. These models are essential for evaluating the impact and cost-effectiveness of future policy transitions, such as adopting a single-dose schedule, expanding vaccination to other cohorts, or introducing higher-valency domestic vaccines, thereby ensuring the national program evolves in a data-driven manner.

Conclusions: The successful transition from national policy to population impact requires a synergistic, learning-based implementation approach. Success requires a coordinated execution framework centered on secured financing, a digitized health information backbone, institutionalizing embedded implementation science and impact surveillance and synchronized public communication. This integrated framework is essential for China to realize the full promise of its elimination strategy.