Abstract
Background: For a decade, most population-based cancer screenings in China are performed by primary healthcare institutions. To assess the determinants of performance of primary healthcare institutions in population-based breast, cervical, and colorectal cancer screening in China. Methods: A total of 262 primary healthcare institutions in Tianjin participated in a survey on cancer screening. The survey consisted of questions on screening tests, the number of staff members and training, the introduction of the screening programs to residents, the invitation of residents, and the number of performed screenings per year. Logistic regression models were used to analyze the determinants of performance of an institution to fulfil the target number of screenings. Results: In 58% and 61% of the institutions between three and nine staff members were dedicated to breast and cervical cancer screening, respectively, whereas in 71% of the institutions ≥10 staff members were dedicated to colorectal cancer screening. On average 60% of institutions fulfilled the target number of breast and cervical cancer screenings, whereas 93% fulfilled the target number for colorectal cancer screening. The determinants of performance were rural districts for breast (OR = 5.16 (95%CI: 2.51–10.63)) and cervical (OR = 4.17 (95%CI: 2.14–8.11)) cancer screenings, and ≥3 staff members dedicated to cervical cancer screening (OR = 2.34 (95%CI: 1.09–5.01)). Conclusions: Primary healthcare institutions in China perform better in colorectal than in breast and cervical cancer screening, and institutions in rural districts perform better than institutions in urban districts. Increasing the number of staff members on breast and cervical cancer screening could improve the performance of population-based cancer screening.
Highlights
Cancer is one of the leading causes of death and a large public health issue in China [1,2].The age-standardized incidence and mortality rate of cancer were 186 and 106 per 100,000 in2015, respectively [3], and the proportion of disability-adjusted life years caused by cancer has risen from 14.6% to 17.1% during the last decade [4]
There were 206 (78.6%), 231 (88.2%), and 261 (99.6%) institutions answering the questions of breast, cervical, and colorectal cancer screenings, respectively
Our results show that the performance in primary healthcare institutions on colorectal cancer screening is better than in breast and cervical cancer screening
Summary
Cancer is one of the leading causes of death and a large public health issue in China [1,2].The age-standardized incidence and mortality rate of cancer were 186 and 106 per 100,000 in2015, respectively [3], and the proportion of disability-adjusted life years caused by cancer has risen from 14.6% to 17.1% during the last decade [4]. Cancer is one of the leading causes of death and a large public health issue in China [1,2]. The World Health Organization recommends that breast, cervical, and colorectal cancers are suitable for screening, and are curable if detected and treated early [5]. A high population coverage and adherence rate are critical factors for a successful screening program, but achieving these goals is challenging for many countries [6,7]. Previous global studies observed that the coverage rate for cervical cancer screening was on average 40% (range 1–80%) in 57 countries, and 19%. Most population-based cancer screenings in China are performed by primary healthcare institutions. To assess the determinants of performance of primary healthcare institutions in population-based breast, cervical, and colorectal cancer screening in China
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
