A study on service capacity of primary medical and health institutions for cervical cancer screening in urban and rural areas in China

被引:17
作者
Li, Yang [1 ,2 ]
Ma, Li [3 ]
Yang, Chunxia [4 ,5 ]
Chen, Zhangya [6 ]
Zhao, Yuqian [7 ]
Dang, Le [1 ]
Lang, Jinghe [8 ]
Qiao, Youlin [1 ]
机构
[1] Chinese Acad Med Sci & Peking Union Med Coll, Natl Clin Res Ctr Canc, Natl Canc Ctr, Dept Epidemiol,Canc Hosp, Beijing 100021, Peoples R China
[2] Chinese Acad Med Sci & Peking Union Med Coll, Inst Med Informat, Div Hlth Informat Disseminat, Beijing 100005, Peoples R China
[3] Dalian Med Univ, Dept Epidemiol, Dalian 116027, Peoples R China
[4] Sichuan Univ, West China Sch Publ Hlth, Dept Epidemiol & Biostat, Chengdu 610041, Sichuan, Peoples R China
[5] Sichuan Univ, West Hosp 4, Chengdu 610041, Sichuan, Peoples R China
[6] Taiyuan Hlth Supervis, Execut Off, Taiyuan 030001, Shanxi, Peoples R China
[7] Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sichuan Canc Ctr, Off Canc Prevent & Treatment,Sch Med, Chengdu 610041, Sichuan, Peoples R China
[8] CAMS PUMC, Peking Union Med Coll Hosp, Dept Obstet & Gynecol, Beijing 100730, Peoples R China
关键词
China; cervical cancer screening; health service capacity; appropriate technology; cytology testing; HPV testing; TRENDS; PERFORMANCE; PREVENTION; MORTALITY; TESTS; WOMEN;
D O I
10.21147/j.issn.1000-9604.2019.05.13
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective: To provide a decision-making basis for sustainable and effective development of cervical cancer screening. Methods: This 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 countylevel/district-level areas in 14 Chinese provinces in 2016. Results: The 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). Conclusions: The 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.
引用
收藏
页码:838 / 848
页数:11
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