Abstract:
Objective To evaluate implementation effectiveness of cervical cancer screening in Xinjiang Uygur Autonomous Region (Xinjiang) for optimizing cervical cancer screening programs.
Methods We extracted and analyzed the data on cervical cancer screening among 438 712 women in rural Xinjiang during 2015 and 2016 from National Cervical and Breast Cancer Screening Information Reporting System.
Results Among the 227 509 and 211 203 women participating cervical cancer screening in 2015 and 2016, the detection rate of cervical intraepithelial neoplasia grade II and above (CIN II+) was 134.06/100 000 (305 cases) and 145.83/100 000 (308 cases); the positive rate of cytology inspection was 3.61% and 5.62%; the abnormal rate of colposcopy examination was 37.47% and 32.13%; the human papillomavirus (HPV) positive rate was 7.52% and 6.66%; there were significant between year differences in the positive rate of cytology inspection (P < 0.001), HPV detection (P = 0.001), and abnormal rate of colposcopy examination (P < 0.001). Significant regional differences in prevalence rate of cervical cancer and precancerosis were observed (P < 0.001) and the rates were higher among the women in southern Xinjiang compared to those in northern and eastern Xinjiang; there were also significant regional differences in prevalence rates of common gynecological diseases such as trichomonas and bacterial vaginitis (P < 0.001), with higher rates among the women in northern Xinjiang. The detection rate of CIN II+ was 0.09%, 0.14%, and 0.21% for the screening with conventional pap smear, thin-prep cytology test (TCT) and HPV preliminary screening, respectively and HPV preliminary screening is superior to other two methods.
Conclusion Certain progress was made in cervical cancer screening program in Xinjiang; thin-prep cytology test performed by well trained medical professionals at grassroots could be adopted in screening program and HPV preliminary screening is an optimal method for cervical cancer screening in the region.