The Ministry of Health and Welfare is considering scaling back its cervical cancer screening program, which covers the cost of annual Pap smears for women over the age of 30, to offering free tests only once every three years.
The government in 1995 began providing free Pap smears as part of the National Cancer Prevention and Control Program.
Last year, 2.17 million women underwent the test, Health Promotion Administration (HPA) data showed.
Fifty-five to 60 percent of women between the ages of 30 and 69 have over the past three years had a free Pap smear under the program, which cost the government about NT$900 million (US$29.44 million) per year, the ministry said, adding that the percentage exceeded 70 percent when women who paid for themselves were included.
The ministry estimated that about 1.6 million women over the age of 30 have not been screened over the past six years.
The US, Canada, Denmark and Norway provide free Pap tests once every three years, HPA Director-General Wang Ying-wei (王英偉) said.
Empirical research has also shown that there is not a great difference in the reduction of cervical cancer incidence among women who were tested every year (93.5 percent), every two years (92.5 percent) and every three years (90.8 percent), Wang said.
Therefore, the effects of providing free Pap smears once every three years would probably be limited, he said.
The money saved could be used to develop other cancer prevention measures, find the people who have never been tested, or include the human papilloma virus test to target people who had previously been affected or are at an increased risk of developing cervical cancer and to bolster prevention and treatment, Wang said.
The prevention and treatment of cancer should incorporate big data and National Health Insurance data to provide people with different screening plans based on their family history or potential risks, he said.
This would better meet the trend toward precision medicine and also prevent the healthcare system from conducting too many screening tests that not everyone might need, he said.
Most countries that offer free Pap smears once every three years have preconditions, said Chen Shee-uan (陳思原), chairman of National Taiwan University Hospital’s Department of Obstetrics and Gynecology Chairman and the vice president of the Taiwan Association of Obstetrics and Gynecology.
These include lowering the frequency of Pap smears to once every three years after having undergone annual tests for a certain period, or extending the interval between the tests for women who are confirmed to be not at high risk, he said.
During annual Pap smears, doctors could also check if women have other gynecological conditions, Chen said.
Chen recommended maintaining the current program.
Cervical cancer is the ninth-most frequent cancer and the seventh-deadliest cancer among women in the nation, according to the HPA’s 2015 Cancer Registry Annual Report.
In 2015, there were 1,485 new cases of cervical cancer and 661 deaths due to cervical cancer, the report said.
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