Taiwan lags behind in cancer primary care network: Chiou

By Alison Hsiao  /  Staff reporter

Tue, Nov 26, 2013 - Page 3

Taiwan lags behind other countries in its cancer primary care network and a system that would remind the public about the screening schedule, despite providing more cancer screening programs than a country like the UK, Health Promotion Administration Director-General Chiou Shu-ti (邱淑緹) said at this year’s Global Health Forum in Taipei.

Chiou said oral cancer was the sixth-most common cancer in the nation, and a screening program for oral cancer was provided in Taiwan, while it was not in the UK.

Kevin Fenton, the director of Health and Wellbeing at Public Health England who made a presentation at the forum introducing the UK’s cancer screening programs, said they are currently being offered for breast, cervical and bowel cancers.

In the UK, women aged 50 to 70 are invited to be screened with mammography for breast cancer, and women aged 25 to 64 are screened for cervical cancer at three-year intervals, with those aged 50 or above at five-year intervals, said Fenton, adding that the country’s bowel cancer screening program invites both men and women aged 60 to 74 at two-year intervals for a guaiac fecal occult blood test (gFOBt).

Taiwan, on the other hand, offers women aged 40 to 44 with a family history of breast cancer and women aged 45 to 69 a mammography every two years; for women aged 30 or above, at least one pap smear is provided every three years; and people aged 50 to 74 are invited to be screened for colon cancer with immunochemical testing, a method believed to be more effective than gFOBt, at two-year intervals.

Chiou added that oral cancer testing program is also offered in Taiwan, the only country in the world to have a government initiated program on oral cancer screening. The policy was pushed by a higher oral cancer death rate (compared with other developed countries) and a high incidence among Taiwanese men, he said

While the four cancer screening programs provided a total of 5 million screenings last year, of which 37,000 precancers and 10,000 cancers were identified, the participation rates have not been as satisfying as England’s, Chiou said.

The participation rates for cervical, breast and colorectal cancer screenings in England are more than 70 percent, 75 percent and 53 percent respectively, whereas those in Taiwan are 70 percent, 34 percent and 34 percent.

Chiou attributed the lower rates to Taiwan’s medical model allowing for random medical visits, a contrast to the UK’s system with registered family doctors or local primary care organizations who can take on the responsibility to call or recall for tests or checkups.