@Article{info:doi/10.2196/51477,
author="Ji, Lu
and Yao, Yifan
and Yu, Dandan
and Chen, Wen
and Yin, Shanshan
and Fu, Yun
and Tang, Shangfeng
and Yao, Lan",
title="Performance of a Full-Coverage Cervical Cancer Screening Program Using on an Artificial Intelligence-- and Cloud-Based Diagnostic System: Observational Study of an Ultralarge Population",
journal="J Med Internet Res",
year="2024",
month="Nov",
day="20",
volume="26",
pages="e51477",
keywords="full coverage; cervical cancer screening; artificial intelligence; primary health institutions; accessibility; efficiency",
abstract="Background: 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. Objective: 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. Methods: 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. Results: 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 {\textyen}49 (the average exchange rate in 2022 is as follows: US {\$}1=CN {\textyen}6.7261) per person, with the primary screening institution and the third-party testing institute receiving CN {\textyen}19 and {\textyen}27, respectively. Conclusions: 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. ",
issn="1438-8871",
doi="10.2196/51477",
url="https://www.jmir.org/2024/1/e51477",
url="https://doi.org/10.2196/51477"
}