Islam Md Foyjul, Nessa Ashrafun, Zaki Quazi Ahmed, Akbar Ashrafi Shah Ali, Qayum Md Omar, Hassan Mohammad Rashedul, Shirin Tahmina
Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh.
Bangladesh Medical University (BMU), Dhaka, Bangladesh.
PLOS Glob Public Health. 2025 May 9;5(5):e0004595. doi: 10.1371/journal.pgph.0004595. eCollection 2025.
Cervical cancer (CC) is the second most prevalent cancer among women in Bangladesh, with 9,640 new cases and 5,826 deaths annually. Since 2018, the Electronic Data Tracking with Population-Based Cervical and Breast Cancer Screening Program (EPCBCSP) has been implemented nationwide across 601 health centers, utilizing Visual Inspection with Acetic Acid (VIA) for CC screening. However, the system had not been evaluated until now. This study aims to assess the performance of EPCBCSP and identify its strengths and challenges. We evaluated EPCBCSP using the updated guidelines from the Centers for Disease Control and Prevention(CDC) in 2023. Data were collected from central level stakeholders and from stakeholders at one colposcopy and one VIA center in each of four selected divisions of Bangladesh. Interviews with 42 stakeholders assessed simplicity, flexibility, acceptability, stability and usefulness attributes. Data quality was assessed by surveillance data review. Percentage scores were calculated and ranked as follows: excellent (≥ 90%), Very good (≥ 80%- < 90%.), good (≥60%- < 80%), average (≥50%- < 60%) and poor (≤50%).The overall system performance was rated as good (score:77.20%). The system's simplicity (score: 91.61%) and usefulness (score:91.61%) were ranked as "excellent". The acceptability (score: 85.29%) was ranked as "very good and flexibility (score:71.90%) was rated as "good". Stability (percentage score: 53.25%) was considered average. Furthermore, data quality was assessed as average based on missing values (13.11%.) Electronic data tracking system, instant test report availability and "see and treat" policies were identified as strengths by stakeholders, while dedicated staff shortages and motivating participants were main challenges. The evaluation EPCBCSP in Bangladesh indicates overall good performance, excelling in simplicity and usefulness. However, improvements are needed in stability and data quality. Strengthening surveillance efforts addressing shortages of dedicated staff and participant motivation will further enhance the effectiveness of the program, crucial for reducing CC burden.
宫颈癌（CC）是孟加拉国女性中第二大常见癌症，每年有9640例新发病例和5826例死亡。自2018年以来，基于人群的宫颈癌和乳腺癌筛查项目电子数据跟踪系统（EPCBCSP）已在全国601个医疗中心实施，利用醋酸目视检查（VIA）进行宫颈癌筛查。然而，该系统此前一直未得到评估。本研究旨在评估EPCBCSP的性能，并确定其优势和挑战。我们使用美国疾病控制与预防中心（CDC）2023年的更新指南对EPCBCSP进行了评估。数据收集自中央层面的利益相关者以及孟加拉国四个选定分区中每个分区的一个阴道镜检查中心和一个VIA中心的利益相关者。对42名利益相关者的访谈评估了简单性、灵活性、可接受性、稳定性和有用性等属性。通过监测数据审查评估数据质量。计算百分比得分并按以下方式排名：优秀（≥90%）、非常好（≥80% - ＜90%）、良好（≥60% - ＜80%）、中等（≥50% - ＜60%）和差（≤50%）。总体系统性能被评为良好（得分：77.20%）。该系统的简单性（得分：91.61%）和有用性（得分：91.61%）被评为“优秀”。可接受性（得分：85.29%）被评为“非常好”，灵活性（得分：71.90%）被评为“良好”。稳定性（百分比得分：53.25%）被认为是中等。此外，基于缺失值（13.11%），数据质量被评估为中等。电子数据跟踪系统、即时检测报告可用性和“即查即治”政策被利益相关者确定为优势，而专职人员短缺和激励参与者是主要挑战。对孟加拉国EPCBCSP的评估表明其总体性能良好，在简单性和有用性方面表现出色。然而，在稳定性和数据质量方面仍需改进。加强监测工作，解决专职人员短缺和参与者激励问题，将进一步提高该项目的有效性，这对于减轻宫颈癌负担至关重要。
