Analysis of cervical cancer screening result of rural women in Ningde,Fujian province,2009-2018

Objective To analyze cervical cancer screening program data for rural women in Ningde, Fujian province, and to learn cervical cancer prevalence and implementation of cervical cancer screening program. Method The data was extracted from quarterly reports of Cervical cancer screening program for rural women in Ningde between 2009 and 2018. Further examination for preliminary positive cases, trends of detection rate of cervical lesions, changes in the detection rate of cervical lesions by different screening methods were compared in groups. PAP smear, liquid-based thin-layer cytology(LBC), and high-risk HPV genetic test(in pilot counties) were chosen as the primary screening methods based on local health economic resources. Women who were positive in preliminary screening were referred for colposcopy, histopathology, and pathology for confirmation. Result A total of 195,299 rural women accepted cervical cancer screening between 2009 and 2018. The detection rates of cervical precancerous lesions and cervical cancer were 710. 71 per 100,000 and 71. 69 per 100,000, respectively. The proportion of positive cases(in the preliminary screening) referred to colposcopy increased steadily; rate of colposcopy increased from 51. 03% to 85. 63%, rate of histopathology increased from 85. 55% to 99. 95%(P< 0. 001, respectively). The detection rate of low grade cervical intraepithelial neoplasia increased from 295. 32/100,000(126/42,666) to 1270. 23/100,000(456/35,899), the detection rate of high grade intraepithelial neoplasia increased from 656. 26/100,000(280/42,666) to 1066. 88/100,000(383/35,899)(both P< 0. 001); Detection rate of adenocarcinoma in situ, microinvasive carcinoma, and invasive carcinoma did not increase significantly; the early diagnosis rate in2012 was 88. 4%, and was > 90% in other years. The proportion of preliminary screening using PAP smear, LBC and HPV test were59. 18%, 25. 2% and 15. 62%, respectively. The detection rates of cervical diseases were 90. 24/100,000(1043/115,583) by pap smear, 174. 3/100,000(858/49,216) by LBC and 296. 07/100,000(903/30,500) by HPV test. The detection rates of cervical diseases and the early cervical cancer diagnosis rates through three preliminary screening methods were statistically different(P<0. 001 and P< 0. 05).Conclusion The detection rates of cervical intraepithelial neoplasia, cervical precancerous lesions and cervical cancer were high among rural women in Ningde, Fujian Province. With the improvement of cervical cancer screening methods and follow-up, the effectiveness of cervical cancer screening has been significantly improved.