Improved screening to lower cervical cancer rate

Deploying diagnostic tools that use artificial intelligence, strengthening grassroots doctors' screening capability and expanding free HPV vaccines are among the crucial steps China is taking to rein in the incidence of cervical cancer and reach goals set by the World Health Organization, health experts said recently.

China records more than 100,000 new cervical cancer cases and around 50,000 related deaths annually. The country also sees an incidence rate that is much higher than four per 100,000 — the threshold determined by the WHO as proof of elimination of the disease.

Qiao Youlin, a professor at the School of Population Medicine and Public Health at the Chinese Academy of Medical Sciences and Peking Union Medical College, said that it usually takes about 10 years from becoming infected and exhibiting precancerous lesions to developing cervical cancer.

"Through prompt detection and treatment during the process, we can prevent related deaths," he said during a recent interview. "However, in less developed regions with poor screening capacity and low health awareness, many women are diagnosed at a late stage and succumb to the disease."

Zhu Lan, head of the obstetrics and gynecology department at Peking Union Medical College Hospital, said that with China's vast territory, it is difficult to improve screening skills in remote areas to the level of major urban hospitals.

"Using artificial intelligence and other new technologies to aid screening and diagnosis will be an important approach to controlling cervical cancer in those regions," she said.

In addition to beefing up early screening, experts also emphasized expanding coverage of HPV vaccines, which fight the cancer-causing human papillomavirus.

China launched a trial program in 15 cities in 2021 that entails free HPV vaccinations and other innovative approaches, aiming to rein in the incidence of cancer. Since then, nine provincial-level regions have offered HPV vaccines for eligible girls, according to the National Health Commission.

Chen Zhao, an official at the National Administration of Disease Control and Prevention, said that the number of HPV doses delivered domestically has been rising steadily, with more than 58 million shots administered nationwide last year.

According to a study released this month by researchers from the Chinese Center for Disease Control and Prevention and local CDC researchers in Fujian province, the annual number of administered HPV doses across the nation has been rising steadily since 2017, when China first approved HPV vaccines for use on the mainland.

As of 2022, coverage of the first HPV vaccination dose rose to 10.1 percent, and three-dose coverage increased to 6 percent.

However, both numbers were lower than the global average, which was estimated in 2019 to stand at 25 percent for the first dose and 15 percent for three doses. There is also a large shortfall from the WHO's target of achieving 90 percent full vaccination among girls under age 15 by 2030, the study said.

The study said that the introduction of two domestically developed HPV vaccines in 2019 and 2022 could help alleviate a shortage of vaccine supplies. It also recommends incorporating HPV vaccines into China's free national immunization program.

"This should involve implementing routine vaccinations to rapidly increase coverage among a wide range of ages, reduce regional disparities and ensure equitable access to this important vaccine," it said.