CLINICAL UNMET NEEDS AND NON-INVASIVE TREATMENT PREFERENCES IN HISL MANAGEMENT: A MIXED-METHODS STUDY IN CHINA
Author(s)
Wei Chen, MHS1, Jian Ming, PhD1, Xuanqi Qiao, MSc1, Xuefei Bai, MSc1, Hongyu Wang, MSc1, Jia Fang, MSc2, Tian Sun, BS2, Jing Wu, PhD3;
1Real World Solutions, IQVIA, Shanghai, China, 2Jiangsu Yahong Meditech Co., Ltd., Jiangsu, China, 3Tianjin University, School of Pharmaceutical Science and Technology, Tianjin, China
1Real World Solutions, IQVIA, Shanghai, China, 2Jiangsu Yahong Meditech Co., Ltd., Jiangsu, China, 3Tianjin University, School of Pharmaceutical Science and Technology, Tianjin, China
OBJECTIVES: High-grade squamous intraepithelial lesion (HSIL) is a prevalent and potentially progressive precancerous cervical lesion requiring timely intervention. While invasive surgery remains standard treatment, significant demand persists for non-invasive alternatives with favourable efficacy. This study explored unmet clinical needs in HSIL management in China and assessed the preference for non-invasive therapies among physicians and patients.
METHODS: A mixed-methods design combining quantitative and qualitative approaches was implemented from April to June 2025. In-depth interviews were first conducted with 5 physicians and 8 patients across 7 provinces to characterize the treatment landscape. Subsequently, a nationwide online survey was conducted among 80 physicians (specialists in gynaecology, cervical medicine, gynaecologic oncology) and 130 patients diagnosed with HSIL from 21 provinces to ensure national representativeness. Invalid responses were excluded, and sampling continued until predefined quotas were met.
RESULTS: Among physicians (66% at associate chief level or above), 50% identified low patient acceptance of surgery and the lack of effective non-invasive alternatives as primary unmet needs, which contribute to both overtreatment and undertreatment. Patients (mean age: 36.3; 63% had undergone cervical surgery) identified key unmet needs: limited pre-diagnosis disease awareness (78%), insufficient understanding of surgical implications for fertility and pregnancy outcomes (e.g. miscarriage, preterm birth; 59%), inadequate knowledge of postoperative recurrence risk (44%), and suboptimal communication regarding treatment options (32%). While surgical efficacy was acknowledged by patients, 87% expressed concerns about fertility preservation, and 86% reported dissatisfaction with postoperative discomfort. Overall, 81% of patients preferred non-invasive therapy as first-line management, and 65% expressed fear of surgery-related adverse health outcomes.
CONCLUSIONS: HSIL management in China shows critical gaps in patient education and shared decision-making. Both physicians and patients emphasize the urgent need for fertility-preserving, non-invasive treatments that ensure safety, efficacy and quality of life. Innovative, patient-centered non-invasive treatments ensuring efficacy and safety are urgently required.
METHODS: A mixed-methods design combining quantitative and qualitative approaches was implemented from April to June 2025. In-depth interviews were first conducted with 5 physicians and 8 patients across 7 provinces to characterize the treatment landscape. Subsequently, a nationwide online survey was conducted among 80 physicians (specialists in gynaecology, cervical medicine, gynaecologic oncology) and 130 patients diagnosed with HSIL from 21 provinces to ensure national representativeness. Invalid responses were excluded, and sampling continued until predefined quotas were met.
RESULTS: Among physicians (66% at associate chief level or above), 50% identified low patient acceptance of surgery and the lack of effective non-invasive alternatives as primary unmet needs, which contribute to both overtreatment and undertreatment. Patients (mean age: 36.3; 63% had undergone cervical surgery) identified key unmet needs: limited pre-diagnosis disease awareness (78%), insufficient understanding of surgical implications for fertility and pregnancy outcomes (e.g. miscarriage, preterm birth; 59%), inadequate knowledge of postoperative recurrence risk (44%), and suboptimal communication regarding treatment options (32%). While surgical efficacy was acknowledged by patients, 87% expressed concerns about fertility preservation, and 86% reported dissatisfaction with postoperative discomfort. Overall, 81% of patients preferred non-invasive therapy as first-line management, and 65% expressed fear of surgery-related adverse health outcomes.
CONCLUSIONS: HSIL management in China shows critical gaps in patient education and shared decision-making. Both physicians and patients emphasize the urgent need for fertility-preserving, non-invasive treatments that ensure safety, efficacy and quality of life. Innovative, patient-centered non-invasive treatments ensuring efficacy and safety are urgently required.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PCR29
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Reproductive & Sexual Health