School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
The Fifth Hospital of Wuhan, Wuhan, China.
J Med Internet Res. 2024 Nov 20;26:e51477. doi: 10.2196/51477.
The World Health Organization has set a global strategy to eliminate cervical cancer, emphasizing the need for cervical cancer screening coverage to reach 70%. In response, China has developed an action plan to accelerate the elimination of cervical cancer, with Hubei province implementing China's first provincial full-coverage screening program using an artificial intelligence (AI) and cloud-based diagnostic system.
This study aimed to evaluate the performance of AI technology in this full-coverage screening program. The evaluation indicators included accessibility, screening efficiency, diagnostic quality, and program cost.
Characteristics of 1,704,461 individuals screened from July 2022 to January 2023 were used to analyze accessibility and AI screening efficiency. A random sample of 220 individuals was used for external diagnostic quality control. The costs of different participating screening institutions were assessed.
Cervical cancer screening services were extended to all administrative districts, especially in rural areas. Rural women had the highest participation rate at 67.54% (1,147,839/1,699,591). Approximately 1.7 million individuals were screened, achieving a cumulative coverage of 13.45% in about 6 months. Full-coverage programs could be achieved by AI technology in approximately 1 year, which was 87.5 times more efficient than the manual reading of slides. The sample compliance rate was as high as 99.1%, and compliance rates for positive, negative, and pathology biopsy reviews exceeded 96%. The cost of this program was CN ¥49 (the average exchange rate in 2022 is as follows: US $1=CN ¥6.7261) per person, with the primary screening institution and the third-party testing institute receiving CN ¥19 and ¥27, respectively.
AI-assisted diagnosis has proven to be accessible, efficient, reliable, and low cost, which could support the implementation of full-coverage screening programs, especially in areas with insufficient health resources. AI technology served as a crucial tool for rapidly and effectively increasing screening coverage, which would accelerate the achievement of the World Health Organization's goals of eliminating cervical cancer.
世界卫生组织制定了全球消除宫颈癌战略，强调宫颈癌筛查覆盖率需达到 70%。为响应号召，中国制定了加速消除宫颈癌行动计划，湖北省采用人工智能（AI）和基于云的诊断系统实施了中国首个省级全覆盖筛查项目。
本研究旨在评估 AI 技术在该全覆盖筛查项目中的表现。评估指标包括可及性、筛查效率、诊断质量和项目成本。
分析了 2022 年 7 月至 2023 年 1 月间 1704461 名筛查者的特征，以评估可及性和 AI 筛查效率。随机抽取 220 名进行外部诊断质量控制。评估了不同参与筛查机构的成本。
宫颈癌筛查服务扩展到所有行政区域，尤其是农村地区。农村女性的参与率最高，为 67.54%（1147839/1699591）。约 170 万人接受了筛查，在大约 6 个月内累计覆盖率达到 13.45%。AI 技术可在大约 1 年内实现全覆盖项目，效率比手动阅片高 87.5 倍。样本符合率高达 99.1%，阳性、阴性和病理活检复查符合率均超过 96%。该项目的成本为每人 49 元人民币（2022 年平均汇率为 1 美元=6.7261 元人民币），初筛机构和第三方检测机构分别收取 19 元和 27 元。
AI 辅助诊断具有可及性、高效、可靠和低成本的特点，能够支持全覆盖筛查项目的实施，尤其是在卫生资源不足的地区。AI 技术是快速有效提高筛查覆盖率的关键工具，有助于实现世界卫生组织消除宫颈癌的目标。
