Editor's Note:
As one of the key actions of the Healthy China initiative, cancer prevention and control has long been a focus of attention at the Two Sessions. During the 2023 national Two Sessions, standardized cancer treatment, early cancer screening and medical insurance policy once again became hot topics.Proposals that drew particularly strong support included: establishing a sound long-term management mechanism for cancer screening together with an interconnected health information system; accelerating the standardized development and management of laboratory-developed tests (LDTs) so as to further raise the level of precision medicine; delivering preventive science communication to the population eligible for early screening; encouraging and guiding high-risk groups to undergo early screening at home; and promoting screening methods for common cancers, such as low-dose spiral CT, as mandatory measures.Since its founding, ProteinT has built its multi-omics precision medicine research, development and services around the central dogma, integrating genomics, proteomics and metabolomics, and is committed to applying innovative technologies to the early screening, early diagnosis and companion diagnosis of tumours. Several of its products have now entered the regulatory filing stage.
Selected Statements from Delegates:
Yu Jinming, Deputy to the National People's Congress, Academician of the Chinese Academy of Engineering and President of Shandong Cancer Hospital:
Establish a Long-Term Mechanism for Cancer Screening, Early Diagnosis and Early Treatment
Yu Jinming proposed: "accelerate the establishment of a sound cancer prevention and treatment model that integrates treatment with prevention. From cancer prevention to early detection, early diagnosis, standardized treatment and accurate assessment of prognosis, this is a systematic endeavour along the whole chain, and I suggest building a full-chain cancer care system." At the same time, he proposed: "conduct long-term tracking and analysis of cancer prevention and treatment outcomes to provide a scientific basis for formulating and adjusting prevention, diagnosis and treatment plans and measures; make full use of big data resources to accelerate the translation and application of artificial intelligence and smart healthcare technologies in cancer prevention and treatment, and continuously raise the level of individualization, precision and intelligence in clinical practice."
Wang Guiqi, Member of the National Committee of the Chinese People's Political Consultative Conference:
Encourage and Guide High-Risk Groups to Undergo Early Screening at Home
Wang Guiqi noted that 190 million people in China are at high risk of digestive tract disease. If all of them were to undergo gastrointestinal endoscopy, the gap between supply and demand — between 38 million and 190 million — would still be enormous. "Gastrointestinal endoscopy should be used for precision screening, diagnosis and treatment, but at present we mostly treat it as a tool for initial screening. The detection rate for tumours or precancerous lesions is not high among the 38 million endoscopies performed each year; for example, for progressing precancerous lesions and adenomas, without a good initial screening the detection rate may be only around 30%," Wang Guiqi said. This also wastes medical resources to some extent and, for some patients, may amount to over-diagnosis and over-treatment.
Wang Guiqi said, "for cancers with a high incidence in our country — oesophageal, gastric and colorectal cancer — development generally proceeds from normal tissue to precancerous lesions, then to early cancer, and finally to middle- and late-stage tumours with clinical symptoms. This process generally takes 10 to 15 years. For people with tumour risk factors or at high risk, regardless of whether they have symptoms, once they reach 50 they should proactively undergo screening, early diagnosis and gastrointestinal endoscopy, so as to avoid the occurrence of late-stage disease."
Dai Lizhong, Deputy to the National People's Congress:
Accelerate the Standardized Development and Management of LDTs and Further Raise the Level of Precision Medicine
"We need to expand, at the national level, the scope of medical institutions included in LDT pilots, accelerate the extension of these pilots from isolated sites to wider areas, and define as soon as possible the LDT management and operation mechanisms, fee standards and the pathway for innovation and translation. At the same time, companies with R&D and innovation capabilities should be encouraged to participate, so as to further accelerate the development and adoption of LDTs in China." During this year's national Two Sessions, Dai Lizhong, Deputy to the National People's Congress and Chairman of Sansure Biotech, submitted a proposal on further accelerating the standardized development and management of LDTs.
Dai Lizhong believes that, for a medical system and a level of healthcare demand as large as China's, the LDTs currently carried out by medical laboratory departments fall short of the urgent needs of domestic medical development in terms of policy oversight, project scale and application coverage. "First of all, we must accelerate the extension of LDT pilots from isolated sites to wider areas," Dai Lizhong said. Expanding the scope of LDT pilots will help to gather information more broadly on operating procedures and accessibility, making it easier to formulate comprehensive policies for LDT projects suited to China's conditions.
Chen Chun, Member of the National Committee of the Chinese People's Political Consultative Conference and President of Fujian Union Hospital of Fujian Medical University:
Promote Screening Methods for Common Cancers, Such as Low-Dose Spiral CT, as Mandatory Measures
"Clinically, more and more lung cancer patients are being detected early through health check-ups, which has greatly improved their five-year survival rate." At present, however, 68% of lung cancer patients in China are still diagnosed at a late stage, which is why the five-year survival rate for lung cancer patients in China remains lower than in some developed countries. "Low-dose spiral CT can detect curable early-stage lung cancer and is recommended around the world as the primary method of lung cancer screening," Chen Chun explained. China has already included low-dose spiral CT screening in its lung cancer screening guidelines, but the proportion of high-risk individuals who actually undergo screening remains low. For this reason, Chen Chun proposed that screening methods for common cancers such as low-dose spiral CT be promoted as mandatory measures.
The number of people developing malignant tumours in China is rising year by year. According to the latest data from the National Cancer Center, the annual number of people living with malignant tumours is expected to reach 5.2 million by 2025. Chen Chun said that in advancing the Healthy China initiative and raising the five-year survival rate of cancer patients, it is crucial to increase participation in early screening among people at high risk of malignant tumours and to move the front line of cancer treatment further upstream.
Ji Jiafu, Member of the National Committee of the Chinese People's Political Consultative Conference, Chief Expert of the Gastrointestinal Center of Peking University Cancer Hospital and Professor of Surgery:
Establish a Sound Long-Term Cancer Screening Management Mechanism and an Interconnected Health Information System
Ji Jiafu proposed: "strengthen supply-side reform in cancer screening, integrate the resources of cancer screening service providers, and establish a sound long-term cancer screening management mechanism and an interconnected health information system." On standardized cancer diagnosis and treatment, Ji Jiafu said: "we need to improve the cancer care quality control system and establish a four-tier cancer quality control network; relying on regional medical centres and provincial cancer quality control centres, we should strengthen the standardized management of diagnosis and treatment, promote coordinated development of cancer care across regions, and achieve the goal of uniform quality in cancer diagnosis and treatment.
Ai Ding, Deputy to the National People's Congress and Professor at the School of Basic Medical Sciences, Tianjin Medical University:
Preventive Science Communication Is Crucial
Professor Ai Ding proposed actively promoting public science education on cancer prevention and treatment throughout society: "for cancer diagnosis and treatment, preventive science communication is crucial. It not only helps the public learn about the causes of cancer in advance and adjust their lifestyles, but also helps to dispel misgivings, enables people to face cancer correctly, and encourages timely participation in early diagnosis and early treatment, thereby lowering incidence and mortality."
Wang Chunxiang, Deputy to the National People's Congress:
Advance Early Screening, Early Diagnosis and Early Treatment of Digestive Tract Tumours
Wang Chunxiang said: "there is still no specific drug for curing cancer; early diagnosis and early treatment are internationally recognized as the most effective means of confronting cancer. The advantages of early diagnosis and early treatment are, first, better efficacy; second, lower cost; and third, less harm."
On this basis, Wang Chunxiang put forward four suggestions: first, strengthen public health education and raise public awareness of early cancer screening and early diagnosis. Second, formulate a national work plan for early screening of malignant digestive tract tumours, giving priority to non-invasive, highly accessible detection methods suitable for large-scale screening, so as to effectively reduce the incidence and mortality of malignant digestive tract tumours in China through long-term, standardized screening. Third, incorporate early screening for digestive tract tumours into the basic public health service programme to effectively reduce the consumption of medical resources. Fourth, encourage innovation in screening methods for malignant digestive tract tumours.
China's early cancer screening market holds enormous potential. Annual medical spending on malignant tumours in China exceeds 220 billion yuan, and has become a major item of expenditure for both households and the medical insurance fund. According to a report released by Frost & Sullivan, the cost of cancer treatment in China is expected to rise to US$351.7 billion in 2023 and to grow further to US$592 billion by 2030. In the field of early cancer screening today, manufacturers, hospitals, the screening population, LDT laboratories and other parties need to work together: establishing a sound long-term cancer screening management mechanism and interconnected health information system, accelerating the standardized development and management of LDTs to further raise the level of precision medicine, delivering preventive science communication to the screening population, and encouraging and guiding high-risk groups to undergo early screening at home. By lowering the cost of early screening, improving its accessibility, and providing the necessary policy support and impetus, participation in "early screening" can be raised.
