%0 Journal Article
%@ 1438-8871
%I JMIR Publications
%V 26
%N 
%P e51477
%T 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
%A Ji,Lu
%A Yao,Yifan
%A Yu,Dandan
%A Chen,Wen
%A Yin,Shanshan
%A Fu,Yun
%A Tang,Shangfeng
%A Yao,Lan
%+ School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China, 86 027 83692727, ylhuster@163.com
%K full coverage
%K cervical cancer screening
%K artificial intelligence
%K primary health institutions
%K accessibility
%K efficiency
%D 2024
%7 20.11.2024
%9 Original Paper
%J J Med Internet Res
%G English
%X 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 ¥49 (the average exchange rate in 2022 is as follows: US $1=CN ¥6.7261) per person, with the primary screening institution and the third-party testing institute receiving CN ¥19 and ¥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. 
%R 10.2196/51477
%U https://www.jmir.org/2024/1/e51477
%U https://doi.org/10.2196/51477