As two major tumors affecting women's health, breast cancer and cervical cancer are regarded as "red face killers". According to the 2020 Global Cancer Centre report released by WHO, breast cancer ranks first in the world in the incidence of malignancy among women worldwide, and one in eight women will have a lifetime risk of breast cancer.
Regular screening is an important means to detect tumors in a timely manner, improve cure rates, and reduce mortality. A number of gynecological oncologists told the first financial reporter that early diagnosis and early treatment are of great significance.
During this year's two sessions, a number of deputies and members suggested early screening and early diagnosis of cancer, and set their sights on the field of high-incidence tumors in gynecology. Yu Jinming, deputy to the National People's Congress, academician of the Chinese Academy of Engineering, and president of Shandong Provincial Cancer Hospital, and Wang Ling, deputy to the National People's Congress, suggested that cervical cancer, breast cancer and other gynecological tumor screening be included in medical insurance.
Seize the only chance to heal
Women's health has received more and more social attention in recent years. For the gynecological tumor screening that was hotly discussed at the two sessions, Dr. Zou Shien of the Obstetrics and Gynecology Hospital affiliated to Fudan University also felt the same way. He told reporters that not all cancers are incurable diseases, and early cervical cancer and precancerous lesions can be cured if they can be detected early and treated in time.
Zou Shien also introduced to the first financial reporter that at present, in Shanghai, the screening of female cervical cancer has been included in medical insurance, and he also supports the inclusion of cervical cancer screening in other parts of the country into medical insurance.
Zou Shien said that the current cervical cancer screening is mainly a shedding cell examination (TCT or LCT) and HPV examination, and the total cost of a test is about 450 yuan.
"We recommend that women who have had sex do a joint screening of TCT and HPV every 1-2 years, if the first step of screening is problematic, they need to continue to do cervical biopsy, biopsy pathology for diagnosis can be said to be the current gold standard for cervical cancer diagnosis." Zou Shien said.
Zhou Zhi, a breast surgeon in Chengdu, Sichuan Province, told reporters that early diagnosis and early treatment of breast cancer are also very important. According to his understanding, in recent years, there are still more women who take the initiative to go to the hospital for breast cancer screening, the reason is generally that there are some small problems found in the previous physical examination.
In terms of breast cancer screening fees, Zhou Zhi introduced that usually the color ultrasound is 100 yuan / time, the breast X-ray is 200 yuan / time, and the magnetic resonance enhancement is 1000 yuan / time.
Along with active active screening, Zhou Zhi told reporters that the proportion of early-stage breast cancer patients in outpatient clinics is relatively high. "Although early breast cancer patients often have mood swings after being diagnosed, because the prognosis is better, they can basically control their mentality during the review process."
In order to detect breast cancer as early as possible, countries such as the United Kingdom and the United States have implemented large-scale screening programs. Due to the difficulty of primary prevention (prevention in daily life), early diagnosis and early standardized treatment as secondary preventive measures for breast cancer are becoming the focus of current cancer prevention and treatment.
"I often say that cancer patients have only one chance to cure, and the first time they seize it, standardize treatment, and the patient is likely to be cured." If the first opportunity is not seized, it is difficult to succeed in developing into the middle and late stages, and then patching treatment. Yu Jinming said in the bill.
He stressed that standardized diagnosis and treatment is the soul of cancer treatment, and only through early screening can the efficacy of patient treatment be truly improved.
Artificial intelligence is gradually entering the field of screening
Deputy Wang Ling also suggested that in terms of breast cancer screening, it is currently necessary to rely on artificial B ultrasound and molybdenum targets, and has high technical requirements for equipment and personnel, and it is difficult to promote them all in rural areas. It is hoped that the state will strengthen investment in artificial intelligence for breast cancer screening.
In addition, Wang Shui, member of the National Committee of the Chinese People's Political Consultative Conference, vice president of Jiangsu Provincial People's Hospital, and director of the Breast Disease Diagnosis and Treatment Center, also said at the symposium on "Standardizing Clinical Use of Tumors and Ensuring Medical Quality and Safety" in February this year that the current demand for breast screening for women in mainland China is gradually rising, but overall, the quality of screening is not high enough. Therefore, it is recommended to add new technologies such as AI to tumor screening to improve the quality of screening.
According to a study published in the journal Nature in 2020, a breast cancer AI screening system jointly developed by the Google Health team in the United States and the team at DeepMind in the United Kingdom conduct large-scale analysis and processing of its breast cancer X-ray imaging data. The results showed that the false-positive rate (misdiagnosis rate) of the AI model test results was 5.7% lower than the diagnosis results of THE US radiologists and 1.2% lower than the misdiagnosis rate of the UK radiologists; the false negative rate (missed diagnosis rate) was 9.4% lower than the diagnosis results of the US radiologists and 2.7% lower than the misdiagnosis rate of the UK radiologists.
At present, in the field of medical imaging in the mainland, there are problems such as a large gap between the supply and demand of doctors, a high threshold for entry, an uneven distribution of medical resources, and a rapid increase in the amount of data. For example, in rural areas and other grass-roots areas for gynecological tumor screening mainly use ultrasound, although there are indicators, but due to differences in techniques and understanding, there are also some problems in the diagnosis of the two cancers. Wang Shui believes that this needs to improve the quality control system of cancer screening.
Last month, the National Health Commission and the National Medical Insurance Bureau and other departments issued the Administrative Measures for mutual recognition of inspection and inspection results of medical institutions, which accelerated the integration and innovation of digital technologies such as AI and 5G with imaging equipment. In the view of Zhang Yihao, president and CEO of GE Healthcare China, this will quickly pull together the examination capabilities of different regions and different levels of medical institutions.
GE Healthcare's recently released "AI Quality Control System" for breast examination, a new module based on the Nova AI breast machine, has achieved the first time in China to achieve full-process quality control based on AI technology for breast disease examination and screening.
Zhang Yihao told the first financial reporter: "In terms of screening for breast cancer and other tumors, intelligent and digital applications are like productivity, and their essence is to promote the sinking of high-quality resources in order to serve patients more efficiently, especially the clinical application based on big data and AI artificial intelligence technology, which can help the whole industry solve the challenges of medical efficiency and quality." ”
SenseTime told reporters that the company has maintained a long-term cooperative relationship with the Department of Pathology of Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine and jointly studied a number of artificial intelligence pathology auxiliary applications. For example, the SenseCare cervical cell pathology assisted analysis system focuses on cervical cell pathology slides with the largest number of slices, the most time-consuming diagnostic methods, and the lowest positive rate.
Through artificial intelligence algorithms, in more than 500 cervical cytology slices per day, the system accurately locates a variety of abnormal cells with tumor tendencies, prompts the negative and negative nature of the slices, and also ensures that the screening and negative rate of negative slices reaches 80% while the abnormal slices are not missed, which greatly reduces the doctor's reading time and reduces the missed examination of human eye diagnosis.
(At the request of the interviewee, Zhou Zhi is a pseudonym in the article)