[Enough science] Using digital technology to improve the level of accurate screening of cervical cancer in areas with low health resources

Cervical cancer is one of the common malignant tumors that seriously threaten women’s health all over the world. At present, the prevention and control of cervical cancer in China is facing the problem of low coverage of screening population, especially in areas with low health resources, and it is difficult to achieve early detection and early treatment of cervical cancer with weak primary screening technology. How to improve the level of cervical cancer screening in areas with low health resources? What role can digital technology play? Distinguished professor Qiao Youlin, School of Medicine and Public Health, Peking Union Medical College, accepted an interview with a reporter from CCTV.

Cervical cancer is different from other cancers. It has a state of precancerous lesions, which can last for 10 years or more. Qiao Youlin said that if the precancerous lesion state is found through high-precision screening, it is simple and cheap to treat at this time, and good treatment results can be obtained.

With the progress of science and technology, the time of cervical cancer screening is gradually advanced. Initially, there were no cytologists and high-tech HPV detection technologies in areas with low health resources. At that time, our obstetrician put acetic acid on the cervix, and if there was any lesion, there would be a white lesion, which was called acetic acid white staining test. Later, it was improved to cytological examination, and whether cytology has changed with a microscope made the diagnosis more accurate. Further development, to use molecular biology methods to check the nucleic acid of the virus. In this way, it can be detected when the virus has just been infected without causing cytopathy. Qiao Youlin said that it is precisely because the World Health Organization has seen that cervical cancer has a vaccine and that screening technology has improved that we can eliminate cervical cancer. .

Each country has its own regulations for defining the age of cervical cancer screening. Generally, the age of government-led screening in our country is defined as 35 to 64 years old. Qiao Youlin said that if ordinary people want to go to the hospital for examination by themselves, they can have a cytological examination at the age of 25. If it is HPV testing, you can do it at the age of 30.

The World Health Organization proposes that cervical cancer should be eliminated globally, and adult women aged 35 -64 should be screened regularly. At present, there are two plans in China: one is to check once every three years and use cytological methods to detect; One is to check once every five years, using HPV detection technology. Qiao Youlin said that adult women between the ages of 35 and 64, if they check every three years, need to check 10 times in their lifetime; If you check it every five years, you only need six checks in your life. In 2019, the state decided to include the "two cancers" screening of cervical cancer and breast cancer in the scope of basic public health services. Qiao Youlin said that it is difficult to implement the policy in areas with low health resources. One is the lack of financial resources, and the other is that the improvement of health service capacity is not so fast. To eliminate cervical cancer in areas with low health resources, it is necessary to find a simpler, easier to operate and more efficient detection technology.

At present, HPV detection technology is being promoted in areas with low health resources. This technology is based on machine detection, which only needs sampling, and the machine produces the results, so it is not necessary to rely on doctors to look for a needle in a haystack under a microscope. Qiao Youlin said that he hopes to train the staff of maternal and child health hospitals in areas with low health resources in three years and teach the grassroots to master this technology, so that the screening of cervical cancer can be continuously promoted.

At present, the most difficult thing in cervical cancer screening is colposcopy biopsy, which is the bottleneck of secondary prevention of cervical cancer, that is, early diagnosis and treatment. Qiao Youlin said that our team is developing an artificial intelligence-based colposcopy biopsy assistant tool with the Health Pratt & Whitney Laboratory of Tencent’s Sustainable Social Value Division. It can be clear where to biopsy, and obtaining accurate biopsy point information will make doctors more confident. Qiao Youlin has been working in the front line of disease prevention and treatment, especially cancer prevention and treatment for a long time. He said that he deeply felt the great changes brought by digital technology, such as the simplest physical examination. You need to know who you are looking for and whether this person meets the conditions for physical examination. Intelligent management of the crowd and dynamic management according to individual’s specific health status make the prevention of diseases more refined and the health service more refined, and the cost-effectiveness is also cost-effective.