Cervical Cancer Screening and Analysis of Potential Risk Factors in 43,567 Women in Zhongshan, China

Objective: The objective of this study was to establish a program model for use in wide-spread cervical cancerscreening.
Methods: Cervical cancer screening was conducted in Zhongshan city in Guangdong province, Chinathrough a coordinated network of multiple institutes and hospitals. A total of 43,567 women, 35 to 59 years ofage, were screened during regular gynecological examinations using the liquid-based ThinPrep cytology test(TCT). Patients who tested positive were recalled for further treatment.
Results: The TCT-positive rate was3.17%, and 63.4% of these patients returned for follow-up. Pathology results were positive for 30.5% of therecalled women. Women who were younger than 50 years of age, urban dwelling, low-income, had a history ofcervical disease, began having sex before 20 years of age, or had sex during menstruation, were at elevated riskfor a positive TCT test. The recall rate was lower in women older than 50 years of age, urban dwelling, poorlyeducated, and who began having sex early. A higher recall rate was found in women 35 years of age and younger,urban dwelling, women who first had sex after 24 years of age, and women who had sex during menstruation.The positive pathology rate was higher in urban women 50 years of age and younger and women who testedpositive for human papillomavirus.
Conclusion: An effective model for large-scale cervical cancer screening wassuccessfully established. These results suggest that improvements are needed in basic education regarding cervicalcancer screening for young and poorly educated women. Improved outreach for follow-up is also necessary toeffectively control cervical cancer.