Clinical Trials Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Dec 24, 2024; 15(12): 1491-1500
Published online Dec 24, 2024. doi: 10.5306/wjco.v15.i12.1491
New cheaper human papilloma virus mass screening strategy reduces cervical cancer incidence in Changsha city: A clinical trial
Yue-E Zu, Si-Feng Wang, Xing-Xing Peng, Yong-Chun Wen, Xue-Xiang Shen, Xiao-Lan Wang, Wen-Bo Liao, Ding Jia, Ji-Yang Liu, Xiang-Wen Peng
Yue-E Zu, Si-Feng Wang, Xing-Xing Peng, Yong-Chun Wen, Wen-Bo Liao, Xiang-Wen Peng, Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care, Hunan Normal University, Changsha 410001, Hunan Province, China
Xue-Xiang Shen, Xiao-Lan Wang, Ding Jia, Changsha Hospital for Maternal & Child Health Care Affiliated, Hunan Normal University, Changsha 410001, Hunan Province, China
Ji-Yang Liu, Department of Administrative Office, Hunan Provincial Health Commission, Changsha 410001, Hunan Province, China
Co-first authors: Yue-E Zu and Si-Feng Wang.
Co-corresponding authors: Ji-Yang Liu and Xiang-Wen Peng.
Author contributions: Zu YE, Wang SF, Peng XX, Wen YC, Shen XX, Wang XL, Liao WB, Liu JY, and Peng XW designed the research study; Zu YE, Peng XX, Wen YC, Shen XX, Wang XL, and Jia D performed the research; Wang SF, Peng XX, and Liu JY analyzed the data and wrote the manuscript. Wang SF’s contributions include design of the study, acquiring and analyzing data from experiments, and writing of the actual manuscript, support that justifies the equal contribution as co-first author. Liu JY’s contributions include design of the study, and writing of the actual manuscript and funding support, support that justifies the equal contribution as co-corresponding author. All authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Changsha Health Minsheng Project Medical Ethics Committee, No. 2024008.
Clinical trial registration statement: We have registered this project at Chinese Clinical Trial Registry (https://www.chictr.org.cn/). The project was approved and the number is ChiCTR2400090454.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The original contributions presented in the study are included in the article and further inquiries can be directed to the corresponding author. Information can be downloaded on the Chinese Maternal and Child Health Monitoring Network http//www.mchscn.org download.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiang-Wen Peng, PhD, Professor, Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care, Hunan Normal University, No. 416 East Chengnan Road, Yuhua District, Changsha 410001, Hunan Province, China. pxw1237@163.com
Received: July 31, 2024
Revised: September 5, 2024
Accepted: October 14, 2024
Published online: December 24, 2024
Processing time: 82 Days and 22.7 Hours
Abstract
BACKGROUND

Cervical cancer is the second leading cause of death in women worldwide, second only to breast cancer. Around 80% of women have been infected with human papillomavirus (HPV) in their lifetime. Early screening and treatment are effective means of preventing cervical cancer, but due to economic reasons, many parts of the world do not have free screening programs to protect women’s health.

AIM

To increase HPV cervical cancer screening in Changsha and reduce the incidence of cervical cancer.

METHODS

Cervical cancer screening included gynecological examination, vaginal secretion examination and HPV high-risk typing testing. Cervical cytology examination (ThinPrep cytology test) was performed for individuals who test positive for HPV types other than 16 and 18. Vaginal colposcopy examination was performed for HPV16 and 18 positive individuals, as well as for those who were positive for ThinPrep cytology test. If the results of vaginal colposcopy examination were abnormal, histopathological examination was performed. We conducted a cost-benefit analysis after 4 years.

RESULTS

From 2019 to 2022, 523437 women aged 35-64 years in Changsha city were screened and 73313 were positive, with a 14% positive rate. The detection rate of precancerous lesions of cervical cancer was 0.6% and the detection rate of cervical cancer was 0.037%. Among 311212 patients who underwent two cancers examinations, the incidence rate was reduced by more than half in the second examination. The average screening cost per woman was 120 RMB. The average cost of detecting early cases was 10619 RMB, with an early detection cost coefficient of 0.083.

CONCLUSION

Our screening strategy was effective and cost-effective, making it valuable for early diagnosis and treatment of cervical cancer. It is worth promoting in economically limited areas.

Keywords: Cervical cancer screening; Human papillomavirus; ThinPrep cytology test; Cost-effective; New cheaper screening strategy

Core Tip: With limited funds, we designed a new strategy for human papillomavirus screening for all women in Changsha every 3 years, to increase screening coverage and reduce the incidence of cervical cancer. From 2019 to 2022, 523437 women aged 35-64 years were screened and there were 73313 human papillomavirus-positive women, with a 14% positive rate. The detection rate of precancerous lesions of cervical cancer was 0.6% and the detection rate of cervical cancer was 0.037%. The average screening cost per woman is 120 RMB, with an early detection cost coefficient of 0.15. Our screening strategy was effective and cost-effective.