Cross-sectional study on the current status of county-level cancer prevention and treatment capabilities in the four southwestern provinces of China

Background The grassroots regions in the four provinces of Southwest China bear a high burden of cancer nationally. In response, the Chinese government has been continuously promoting the construction of a grassroots cancer prevention and treatment system. This study aims to systematically evaluate the current capacity for cancer prevention and treatment at the county level in this region, aligning with the “Healthy China” strategy and the “Thousand-County Project” policy objectives. Methods This cross-sectional study was conducted from December 2023 to March 2024. A standardized online questionnaire was distributed to 470 district and county (city) level hospitals across four provinces in Southwest China (Yunnan, Sichuan, Guizhou, and Guangxi). The survey investigated the availability of hardware facilities, staffing levels, and clinical practice standards related to cancer care. Descriptive statistical analysis was used to assess the current status of cancer prevention and treatment resources and capabilities. Comparisons between groups for categorical variables were performed using the chi-square test, while continuous variables were compared using the t -test or Wilcoxon rank-sum test, with a significance level set at α = 0.05. All analyses were conducted using SPSS software version 22.0. Results Tertiary hospitals dominate county-level cancer prevention and control in the four southwestern provinces (63.6%), and 46.1% of cancer prevention and control hospitals have established cancer prevention and control centers. Imaging examination coverage is high (CT/MRI coverage rates of 97.5/88.4%), and access to conventional cancer treatment methods is good (access rates for curative surgery, targeted therapy, chemotherapy, endocrine therapy, and immunotherapy are 79.1, 97.5, 96.4, 83.2% and 87.3%, respectively). Multidisciplinary diagnosis and treatment models are developing rapidly (MDT implementation rate of 56.8%), and pathology support is strong (77.8% of hospitals conduct pathological diagnosis). However, the configuration of radiotherapy equipment is significantly insufficient (0.16 linear accelerators per county on average); the rate of independently conducted gene testing is only 16.2%. The accessibility of analgesic drugs exceeds 80%. Conclusions Basic clinical capabilities for cancer prevention and treatment at the county level in the four provinces of Southwest China are developing rapidly. The district and county (city) level cancer hospitals demonstrate high accessibility to conventional treatment modalities (surgery, chemotherapy, targeted therapy, immunotherapy, pain management, etc.) and imaging/pathological diagnostics. However, challenges remain in advanced areas of precision medicine, such as a significant lack of genetic testing capacity. Additionally, while the MDT model is progressing quickly, it still lags behind levels seen in developed countries. Finally, radiotherapy resources at the county level in this region are insufficient and unevenly distributed.