Objective To explore status of breast cancer screening and characteristics of spatial aggregation among women aged 35 − 64 years in Guangdong province in 2023, so as to provide scientific evidence for prevention and control of breast cancer in Guangdong.

Methods The population screening rate, detection rate, early diagnosis rate and treatment rate of breast cancer in 21 cities were retrieved from the annual report of women’s cervical and breast cancer screening program in Guangdong province in 2023 descriptive statistics was conducted through SPSS 25.0, and spatial autocorrelation and hotspot analysis was conducted through Arc GIS Pro 3.0 software.

Results In 2023, the population screening rate, detection rate, early diagnosis rate, and treatment rate of breast cancer in Guangdong province were 53.48%, 128/100 000, 68.39%, and 96.91%, respectively. The population screening rate of breast cancer in Guangdong province among women of the appropriate age group showed the characteristics of clustered distribution (global Monran’s I value = 0.616, P < 0.001), but no significant globally spatial autocorrelation was observed in the provincial early diagnosis rate, detection rate, and treatment rate. The results of local spatial autocorrelation disclosed that the screening rate of breast cancer in Guangzhou city showed high value-high value clustering while the detection rate of breast cancer showed low value-low value clustering. The hot spots of breast cancer screening among women of the appropriate age were mainly concentrated in the Pearl River Delta region (Guangzhou, Foshan, Dongguan, Zhongshan, Shenzhen, and Zhuhai city), while the cold spots were mainly concentrated in the eastern part of Guangdong Province (Jieyang, Shangtou and Shanwei city). There were no difference between cold spots and hot spots in terms of breast cancer early diagnosis rate, detection rate, and treatment rate.

Conclusion  The geographical disparity in breast cancer screening and detection rate across Guangdong province warrants greater attention—specifically, the Pearl River Delta region exhibits high screening rate but low detection rate, while eastern and western Guangdong show the opposite pattern with low screening rate but high detection rate. Further analysis on the factors associated with population-based breast cancer screening rates in different regions of Guangdong should be conducted so as to provide scientific evidence for formulating more targeted regional breast cancer prevention and control strategies.