Abstract
ObjectiveTo provide a decision-making basis for sustainable and effective development of cervical cancer screening.MethodsThis cross-sectional study assesses the service capacity to conduct cervical cancer screening with a sample of 310 medical staff, medical institutions and affiliated township health centers from 20 county-level/district-level areas in 14 Chinese provinces in 2016.ResultsThe county-level/district-level institutions were the main prescreening institutions for cervical cancer screening. More medical staff have become engaged in screening, with a significantly higher amounts in urban than in rural areas (P<0.05). The number of human papillomavirus (HPV) testers grew the fastest (by 225% in urban and 125% in rural areas) over the course of the project. HPV testing took less time than cytology to complete the same number of screening tasks in both urban and rural areas. The proportion of mid-level professionals was the highest among the medical staff, 40.0% in urban and 44.7% in rural areas (P=0.406), and most medical staff had a Bachelor’s degree, accounting for 76.3% in urban and 52.0% in rural areas (P<0.001). In urban areas, 75.0% were qualified medical staff, compared with 68.0% in rural areas, among which the lowest proportion was observed for rural cytology inspectors (22.7%). The medical equipment for cervical pathology diagnosis in urban areas was better (P<0.001). HPV testing equipment was relatively adequate (typing test equipment was 70% in urban areas, and non-typing testing equipment was 70% in rural areas).ConclusionsThe service capacity of cervical cancer screening is insufficient for the health needs of the Chinese population. HPV testing might be an optimal choice to fill the needs of cervical cancer screening given current Chinese medical health service capacity.
Highlights
Cervical cancer is a common cancer that seriously threatens the health of females worldwide
With a convenience sampling method, 340 township health centers and 20 primary medical institutions in 20 counties or districts that conducted the National Cervical Cancer Screening Program (NCCSP) were selected from 14 provinces (Table 1), and 310 medical staff who participated in cervical cancer screening were investigated
Completion of cervical cancer screening tasks in medical institutions An analysis showed that the county/district-level medical institutions that were the main implementer of NCCSP in urban and rural areas provided most cervical cancer screening services
Summary
Cervical cancer is a common cancer that seriously threatens the health of females worldwide. In 2018, there were approximately 570,000 new cases and 311,000 death cases from cervical cancer worldwide [1]. As the largest developing country with a great disease burden of cervical cancer, China plays an important role in achieving the global elimination goal. In 2009, China launched a new round of medical system reforms and proposed the implementation of major national public health service projects [9]. As a part of this health care reform, China’s government launched a major public health service project, namely, the National Cervical Cancer Screening Program (NCCSP) [10], which has played an important role in preventing cervical cancer and ensuring women’s health in China [11]
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