演讲嘉宾

Dr. Wenjie Zhang, Professor

Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Biography: Dr. Wenjie Zhang is a professor in the Department of Pathology, Shihezi University School of Medicine. 2007-present, Doctor at Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology; 2003-2007, Professor of Oncology, Wuhan University Zhongnan Hospital; 2007-2011, Professor of Immunology, Tongji Medical College, Huazhong University of Science and Technology; 2009-2024, Professor of Oncology/Pathology, Shihezi University School of Medicine, Xinjiang, China. His main research directions are the prevention and early diagnosis and treatment of cancer, including: cervical cancer and gastric cancer, tumor cell signal transduction and cancer invasion and metastasis, tumor etiology and pathogenesis, and clinical tumor genetic counseling. He has published 85 papers indexed by SCI journals, with a total impact factor of 282.539.

Topic: Introducing A New Strategy For Cervical Screening In Developing Countries: The Same-day “Screen-and-Diagnosis” Screening Incorporates Visual Inspection, Pap Test and Biopsy

Abstract: Background: Among all cancers, cervical cancer is one typical example of public health disparity worldwide and a majority of cases and deaths occurs in developing countries. Despite widespread implementation of effective screening strategies, including TCT and HPV technologies, the last 3 decades have witnessed 20% increase in cervical cancer cases worldwide and 23% of the total deaths are aged 15-49 years in developing countries. Therefore, a suitable screening strategy is much needed in developing countries which should be sensitive and cheap to detect cervical cancer. This lecture summarizes the advantages/disadvantages of cervical screening strategies, including visual inspection (VIA), Papanicolaou (Pap) test, TCT and HPV testing and particularly, introduces a new strategy termed as "screen-and-diagnosis" cervical screening. Development of the Strategy: Two typical low-income Muslim Uyghur communities in China’s far western Kashi Prefecture served as pilot and validation study sites, respectively, and 4,049 women (30-59 years) were screened. Conventional Pap smear was modified (mPap) using a cotton-swab to collect cervical cells without scraping the cervix using an Ayre spatula, allowing VIA and mPap performed in a single-visit. The same-day biopsy was performed for woman positive for either or both tests. Fixed biopsies were shipped via postal/courier services to pathology laboratory for diagnosis. Advantages of the Strategy: The mPap allowed VIA and mPap (VIA+mPap) being completed within 1-2 hours, making immediate biopsy possible. The same-day VIA+mPap screening achieved a sensitivity of 96.0% (95% CI, 91.6-100) superior to VIA (48%, 95% CI, 36.7-59.3; P<0.001) or mPap (76%, 95% CI, 66.3-85.7; P<0.001) alone in detecting CIN2+ lesions. The VIA+mPap screening resulted in more referrals for biopsy and achieved a NPV of 98.2% in detecting CIN2+ lesions. The increased sensitivity and minimized loss-of-follow-up allowed this approach to reveal extremely high prevalence of CIN1 (2,741/100,000, 95% CI, 2,238-3,245/100,000), CIN2+3 (1,457/100,000, 95% CI, 1,088-1,826/100,000), and cervical cancer (395/100,000, 95% CI, 202-589/100,000) among these women. Summary: The same-day VIA+mPap "screen-and-biopsy" or "screen-and-diagnosis" approach has greater sensitivity to detect high-grade CINs, results in more referrals for biopsy, and reduces loss-of-follow-up. Importantly, the VIA+mPap strategy has similar sensitivity and NPV to HPV molecular screening. The VIA+mPap screening is cost-effective and convenient to perform in basic medical facilities by "village doctors" after training, who can serve massive female populations in countryside and mountain areas which certainly scale-up the National "Tow Cancers Screening Program" at much lower costs.