Current status and capabilities of cancer prevention and treatment in county-level hospitals in Fujian Province: a baseline survey under the hierarchical medical system

This paper presents an overall estimate on the current status and capabilities of cancer prevention and treatment at selected county-level hospitals in Fujian Province (southeast China) to obtain baseline data for further development, construction, and reformation of county-level cancer prevention and treatment centers under the hierarchical medical and healthcare system. A province-wide survey was conducted by Fujian Cancer Hospital from June to August 2025 using a custom-made ordinary questionnaire of 40 questions to investigate cancer-specific medical resources and the comprehensive service capabilities of 35 targeted county-level hospitals in 33 counties. Effective feedback was reported by 33 participating hospitals in 31 counties. The results are analyzed via self-programmed Python codes. The following results are obtained: (a) Twenty-five participating county-level hospitals have no independent cancer-specific wards; 29 participating county-level hospitals face a shortage of medical staff; and medical devices can meet the demand of primary diagnosis and treatment; (b) Insufficient prevention and screening is reported: 16, 9, and 12 county-level hospitals have never conducted cancer risk assessment, high-risk group management, and cancer screening, respectively; (c) Full coverage of cancer multidisciplinary teams (MDTs) has yet to be achieved, and 8 hospitals have no comprehensive treatment standardization, regulation, or implementation; (d) Bidirectional referral is still ineffective due to lack of referral regulation, and 16 participating county-level hospitals have conducted fewer than 10 cases in the past year; (e) Cancer information platforms and cancer-specific databases are still in the early stages and need substantial and sustained effort. Further development of county-level cancer prevention and treatment centers is necessary to increase medical resources for cancer prevention and treatment, enhance cancer prevention and treatment capabilities, and promote the implementation of hierarchical diagnosis and treatment in cancer-specific fields.