Context While road traffic mortality has been reported to be seriously undercounted by the police in China, non–police-reported data have not been explored previously to examine vulnerable road user mortality.

Objective To examine changes in bicyclist mortality between 2006 and 2010 in China, using the Disease Surveillance Points (DSP) data of China.

Design, setting and data source Mortality data of 2006–2010 from DSP data, covering 73 million population, was analysed. Poisson regression was used to examine the significance of year after controlling for sex, age and urban/rural location.

Main outcome measure(s) Mortality rate and mortality rate ratio (MRR).

Results Between 2006 and 2010, the mortality rate for bicyclists increased from 1.1 to 1.6 per 100 000 population according to DSP data. Between 2006 and 2010, more than 90% of bicyclist deaths were undercounted by the police compared to the findings from DSP data. Contrary to the 34% increase between 2006 and 2010 reflected by DSP data (adjusted MRR: 1.34, 95% CI 1.23 to 1.46), police data revealed a 64% decrease in bicyclist mortality (unadjusted MRR: 0.36, 95% CI 0.32 to 0.40) in the study time period.

Conclusions Health data should be used to assess the road traffic injuries in China. The recent increase in bicyclist mortality merits attention from policy makers and researchers.