"By 2025, try to promote HPV vaccination services for school-age girls; the cervical cancer screening rate for school-age women will reach 50%; the treatment rate for patients with cervical cancer and precancerous lesions will reach 90%." A few days ago, the National Health Commission and other ten departments jointly issued The "Action Plan for Accelerating the Elimination of Cervical Cancer (2023-2030)" proposes the main goal of accelerating the elimination of cervical cancer.
February 4th is World Cancer Day.
Cervical cancer is one of the most common malignancies among women worldwide.
What are the shortcomings of eliminating cervical cancer?
The "Xinhua Viewpoint" reporter investigated this.
About 100,000 women are newly diagnosed with cervical cancer every year in my country
"Cervical cancer, endometrial cancer, and ovarian cancer are three types of gynecological malignancies with a higher incidence in women. Among them, cervical cancer is the only cancer with a clear etiology, the only preventable cancer, and the only cancer that can be basically eliminated." Harbin Tan Wenhua, director of the Department of Obstetrics and Gynecology at the Second Affiliated Hospital of Medical University, said that the main cause of the disease is the persistent infection of high-risk human papillomavirus (HPV), which determines the feasibility of eliminating cervical cancer.
Statistics from the World Health Organization show that there will be about 600,000 new cases of cervical cancer worldwide in 2020.
The "Global Strategy to Accelerate the Elimination of Cervical Cancer" released by the World Health Organization in 2020 announced that 194 countries around the world will work together to achieve these goals by 2030: 90% of girls will complete HPV vaccination before the age of 15; 70% of women will be vaccinated before the age of 35 and before the age of 45 are screened with highly effective tests; 90% of women diagnosed with cervical disease are treated.
About 100,000 women are newly diagnosed with cervical cancer in my country every year.
As a country with a large burden of cervical cancer, my country's prevention and control strategy is a positive response to the World Health Organization's initiative to eliminate cervical cancer.
According to Hua Keqin, Secretary of the Party Committee and second-level professor of the Obstetrics and Gynecology Hospital Affiliated to Fudan University, cervical cancer prevention and treatment mainly includes a three-level system: vaccination, regular screening, and early treatment.
Popularization and proper application of these three methods can effectively reduce the incidence and mortality of cervical cancer.
Vaccination against HPV is one of the effective ways to prevent cervical cancer.
According to Luo Chao, director of the Immunization Planning Institute of the Harbin City Center for Disease Control and Prevention in Heilongjiang Province, women of the right age can make appointments in advance to receive bivalent, quadrivalent, and nine-valent HPV vaccines at community health service centers.
In addition, early screening of cervical cancer is also crucial, and related medical technologies have made significant progress in recent years.
Many challenges remain in eradicating cervical cancer
Industry insiders pointed out that my country still faces many challenges on the road to eliminating cervical cancer, including a large population base, weak awareness of cervical cancer prevention, unbalanced regional economic and health development levels, and limited prevention and treatment conditions.
The reporter's investigation found that, compared with cities, the morbidity and mortality of cervical cancer in rural areas are still higher; at the same time, the relevant data in underdeveloped areas are also higher than in developed areas.
"A needle is hard to find" is a common problem faced when vaccinating the nine-valent HPV vaccine.
According to many interviewees, the waiting time for bivalent domestic vaccines is about one to two months after making an appointment, while the quadrivalent and nine-valent vaccines are imported vaccines, the supply is not stable enough, and the waiting time is longer, some as long as half a year. Long.
"The price of the quadrivalent vaccine is 798 yuan, the price of the nine-valent vaccine is 1298 yuan, and there is also a vaccination fee of 16 yuan. After three injections, it is not a small burden for some women." A staff member of a community health center in Harbin told reporters reporter.
In addition to vaccinations, regular screenings are also important.
It is understood that due to relatively backward large-scale screening products and technologies in some areas of my country, and limited grassroots service capabilities, the penetration rate of cervical cancer screening is still not high.
"Many women think that they don't need to be screened if they have been vaccinated. This is wrong." Hua Keqin pointed out that the nine-valent vaccine targets nine subtypes, including HPV6 and HPV11, and can prevent about 92% of cervical cancers. However, there are still some viruses that are not covered, and it cannot be guaranteed that the vaccinators have not been infected with HPV virus before injection, so regular screening is still very necessary.
"Constrained by the lack of attention and the shortage of professional talents, the publicity and popularization of cervical cancer prevention and treatment at the grassroots level is still not enough. Many people are already in the advanced stage when they are admitted to the hospital for treatment." Tan Wenhua said that if the early symptoms do not arouse enough vigilance and allow the disease to develop and worsen, the consequences will be severe. Including removal of the uterus, removal of ovaries and fallopian tubes, etc., and even life-threatening.
"Cervical cancer needs early detection and early treatment, which still has a long way to go for my country's current medical system." Hua Keqin pointed out that the uneven distribution of medical resources, the shortage of professionals in grassroots hospitals, and the lack of key equipment, coupled with some medical staff's concern for cervical cancer Insufficient standardization of cancer treatment will have an impact on the actual prevention and treatment effect.
A multi-pronged approach to promote "comprehensive elimination"
On August 1, 2020, a dose of HPV vaccine was slowly injected into the arm of a 14-year-old girl in Zhungeer Banner, Ordos. Zhungeer Banner became the first county-level area where the government vaccinated all middle school girls for free. .
In recent years, many places across the country have gradually promoted the universal vaccination strategy of HPV vaccine for women of appropriate age. At present, Ordos in Inner Mongolia, Lianyungang in Jiangsu, Jinan in Shandong, Xiamen in Fujian, Chengdu in Sichuan and other places have launched free or subsidized vaccination programs for bivalent HPV vaccines. More and more Women of eligible age can get the HPV vaccine free of charge.
Strengthening women's awareness of self-care, voluntary vaccination, and regular inspections are the "first line of defense" to prevent cervical cancer.
Experts believe that the best time to inoculate the HPV vaccine is "before the first sexual life", and vaccination is still the most cost-effective method of prevention.
The reporter learned from the National Health and Medical Commission that the "Action Plan for Accelerating the Elimination of Cervical Cancer (2023-2030)" emphasizes the need to strengthen cooperation between government departments, the media and other social groups, promote the establishment of a diversified fund-raising mechanism, and concentrate all parties We will vigorously promote the cause of cervical cancer prevention and mobilize the whole society to support and participate in the elimination of cervical cancer.
Luo Chao suggested that the elimination of cervical cancer can be achieved by promoting vaccination and early screening through multi-party cooperation with social forces such as foundations, social organizations, and caring enterprises.
At the same time, the establishment of a prevention and control collaboration network and the application of better screening methods are empowering "early detection and early treatment".
In 2021, the "Red House Collaborative Group for Cervical Cancer Prevention and Control" initiated by the Obstetrics and Gynecology Hospital of Fudan University will be formally established, and 35 collaborating units will join the collaborative group online.
Hua Keqin introduced that relying on this platform, various units will work together to establish a high-quality full-process cervical cancer prevention and control collaboration network to further enhance the local units' cervical cancer prevention and control capabilities.
In addition, the establishment of the local cervical cancer comprehensive diagnosis and treatment center has laid a solid foundation for the construction of a multidisciplinary cervical cancer diagnosis and treatment and telemedicine service system.
For example, the Shanghai Cervical Cancer Comprehensive Diagnosis and Treatment Center, established last year, has further improved the ability of cervical cancer diagnosis and treatment by improving the construction of the diagnosis and treatment system.
The improvement of the diagnosis and treatment level of medical personnel is also a necessary condition for the elimination of cervical cancer.
Tan Wenhua suggested that, on the basis of early diagnosis and early treatment, special training for medical personnel should be combined with the application of new treatment methods, and all efforts should be made to make cervical cancer the first malignant tumor to be completely eliminated in human beings.
(Reporters Chen Cong, Yang Siqi, Gong Wen)
Xinhua News Agency, Beijing, February 4th
(Xinhua Daily Telegraph)