Cervical cancer screening service policies in China, 2006 – 2023: a quantitative analysis of government documents

Abstract

ObjectiveTo analyze the content and shortcomings of policy documents for cervical cancer screening service issued by government agencies in China and to provide suggestions for optimizing policies for cervical cancer screening service in the future. MethodsWe retrieved policy documents on cervical cancer screening services issued by government agencies from 2006 to 2023 through official websites such as the Chinese Government Network, the National Health Commission of China, the Chinese Center for Disease Control and Prevention, and platforms such as the PKU Law database. Content analysis was used to construct a three-dimensional policy instrument – policy objective – policy strength framework for quantitative analysis of national-level cervical cancer screening policy documents. ResultsThis study included 37 policy documents related to cervical cancer screening services, with 174 policy items coded. Among them, the policy items for cervical cancer screening service environment were mentioned most (50.57% of all coded items), and the items for government objective were mentioned least (14.95%), and no items were mentioned for cancer screening service-related government procurement and medical insurance payment. A total of 149 items for cancer screening service-related administrative objective were coded, among which the proportion of items for optimizing the long-term operation mechanism of screening is the highest (52.34%). The average policy strength score for all retrieved documents is 2.54. The analyzed policy documents are mainly issued in the form of non-legislative documents, such as notices. Policy documents with a strength score of ≥ 4 points account for only 21.62% of all documents, and there are few items related to cervical cancer screening services in the documents. In terms of the three dimensions of the documents, the mean strength score (2.83) was highest for policies on the operating environment of screening services, followed by 2.47 for those on government objective and 2.33 for those on provision; on the aspect of government objective, the lowest strength score (2.00) was for policies on promoting relevant information management; the strength scores fluctuated around 2.59 for policies on other aspects related to screening services. ConclusionThe internal structure of policy instruments for cervical cancer screening services in China is uneven, and the structure of policy objectives needs to be optimized. Different policy units have different focuses on the implementation and concern for cervical cancer screening services, and there is insufficient cooperation among different departments. Therefore, it is necessary to further strengthen the top-level policy design to promote the implementation of cervical cancer screening services in China.

Keywords

• cervical cancer
• screening service
• policy
• quantitative analysis