Scatter Chart Visualisation of the Two-Pronged Approach to Primary and Secondary Cervical Cancer Prophylaxis for Cancer Control: A Report From Japan

Abstract

Background: Cervical cancer is a notable vaccine-preventable disease. Previous studies support a two-pronged approach incorporating human papillomavirus (HPV) vaccination and cervical screening. Diagrams enabling the visual evaluation of cervical cancer control by displaying the HPV vaccination and cervical screening rates are lacking in both small jurisdictions and at the nation/country level. This study generated a simple scatter chart displaying both rates, enabling the identification of a relevant area in which to investigate concrete primary and secondary prophylactic measures. Methods: Data on HPV vaccination and cervical screening from local governments in Wakayama, Japan, were obtained from e-Stat for the following populations: the target population for HPV vaccination in 2013, vaccinated people, and women aged ≥ 20 years who had undergone cervical screening. The relationship between the HPV vaccination and cervical screening rates was analysed in eight public health centre units, and a scatter chart was created with prefectural average values. Then, one local government with relatively high HPV vaccination and cervical screening rates was selected for a historical case study with archived documents. Findings: HPV vaccination and cervical screening rates differed substantially among the relevant units (highest: 47.1% and 50.4%; lowest: 8.1% and 36.8%). We constructed scatter charts with four profiles of vaccination and screening rates (high-high, high-low, low-high, and low-low). Good-practice areas were characterised by the systematic implementation of community- and school-based cervical cancer awareness programmes and personalised information provision. Interpretation: This scatter chart visualises the two-pronged approach to primary and secondary cervical cancer prophylaxis for cervical cancer control in relevant areas. Such charts can help local governments prioritise measures for cervical cancer control among target residents. To promote cervical cancer control, a plan-do-check-act cycle should be implemented in the relevant cancer control area through a person-centred perspective for target residents, especially those who have missed HPV vaccinations. Funding: None. Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: Not applicable.