Background: The performance of lung cancer screening with low-dose computed tomography (CT) (LDCT) in China is uncertain. This study aimed to evaluate the performance of LDCT lung cancer screening in the Chinese setting. Methods: In 2014, a screening cohort of lung cancer with LDCT was established in Gejiu, Yunnan Province, a screening center of the Lung Cancer Screening Program in Rural China (LungSPRC). Participants received a baseline screening and four rounds of annual screening with LDCT in two local hospitals until June 2019. We analyzed the rates of participation, detection, early detection, and the clinical characteristics of lung cancer. Results: A total of 2006 participants had complete baseline screening results with a compliance rate of 98.4%. Of these, 1411 were high-risk and 558 were nonhigh-risk participants. During this period, 40 lung cancer cases were confirmed, of these, 35 were screen-detected, four were post-screening and one was an interval case. The positive rate of baseline and annual screening was 9.7% and 9.0%, while the lung cancer detection rate was 0.4% and 0.6%, respectively. The proportion of early lung cancer increased from 37.5% in T0 to 75.0% in T4. Adenocarcinoma was the most common histological subtype. Lung cancer incidence according to the criteria of LungSPRC and National Lung Cancer Screening Trial (NLST) was 513.31 and 877.41 per 100 000 person-years, respectively. Conclusions: The program of lung cancer screening with LDCT showed a successful performance in Gejiu, Yunnan. However, further studies are warranted to refine a high-risk population who will benefit most from LDCT screening and reduce the high false positive results. Key points: This study reports the results of lung cancer screening with LDCT in Gejiu, Yunnan, a high-risk area of lung cancer, and it demonstrates that lung cancer screening with LDCT is effective in detecting early-stage lung cancer. Our program provides an opportunity to explore the performance of LDCT lung cancer screening in the Chinese context.

Background: In mainland China, HPV vaccines have been available to the public. However, only a few related studies among health care providers, as the key information providers, were reported although public concerns on HPV vaccines still exist. In this study, we aim to assess the knowledge of HPV, its vaccines, and attitudes toward HPV vaccines among the three most important groups of health care providers in Western China. Method: This was a cross-sectional questionnaire-based study. Health care providers including obstetrician-gynecologists (OB-GYNs), pediatricians, and immunization service providers in Western China were investigated regarding their knowledge of HPV and its vaccines and their attitudes toward HPV vaccines. Results: Of 1079 health care providers completing the survey, 1015 (94.1%) knew HPV infection is the primary cause of cervical cancer. However, lower knowledge levels of other HPV-related diseases were also found (43.2%). About three-quarters (74.1%) of practitioners interviewed would be willing to recommend HPV vaccination, which was found to be lower among the OB-GYNs (69.6%) and the pediatricians (73.2%). "Lack of relevant knowledge," "concerns on safety and efficacy" and price were the three most important concerns surrounding HPV vaccination. Conclusion:The interviewed practitioners did not have adequate knowledge of HPV and its vaccines in depth. Education interventions are highly recommended to the health care providers, especially for OB-GYNs and pediatricians, to increase the coverage of HPV vaccination among the population. For the currently high price of vaccines, a future co-sharing mechanism between the government, the providers, and the individuals might be a solution.

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ObjectivesThis study aimed to understand the early development and nurturing care environment of children aged 0–6 years in rural China and to evaluate the sex‐ and age‐specific associations of nurturing care environment with child developmental outcomes.MethodsA cross‐sectional survey involving 2078 children aged 0–6 years was conducted using a stratified cluster sampling strategy. We used face‐to‐face interviews to collect information on child, family and nurturing care. The Ages & Stages Questionnaires‐Chinese version and ASQ: Social‐Emotional were applied to assess children's neuro‐ and social–emotional development, respectively. Lower neurodevelopmental scores indicate an increased risk for neurodevelopmental delay, and higher social–emotional scores are indicative to a risk of social–emotional problems. The multiple linear regression model examined the associations of nurturing care environments with childhood development.ResultsAmong the investigated children, the average age was (42.9 ± 19.8) months and 55.8% were boys; 67.9% of the children had absent fathers because of labour migration and 54.0% had limited access to books and toys. Overall, boys had a lower total neurodevelopmental score than girls; similar gender patterns were also found in the domains of communication, fine motor, problem‐solving and person‐social. Concurrent absent fathers and limited access to books and toys were significantly associated with reduced neurodevelopmental scores [β − 11.44, 95% CI (−18.20, −4.68)] and increased social–emotional developmental scores [β 5.88, 95%CI (1.35, 10.41)] after controlling for confounding factors. Sex‐specific analysis only echoed the results in boys. Additionally, having an absent father and limited access to books and toys was associated with lower neurodevelopmental scores [β − 14.58, 95%CI (−25.41, −3.75)] in children under 3 years of age and higher social–emotional developmental scores among children aged 3–6 years [β 10.66, 95%CI (5.09, 16.24)].ConclusionsChildren, especially boys, with absent fathers due to labour migration have poorer neuro‐ and social–emotional development. Limited access to books and toys and father absence are linked to the children's developmental delay, especially for those under 3 years of age. Our findings suggest that intervention programs in resource‐constrained rural areas are desirable; more importantly, such programs should begin before 3 years of age to achieve a benefit–cost outcome.