The requirements for free colon cancer screenings would be relaxed from this year to include people aged 45 to 49, as well as those aged 40 to 44 with a family history of the disease, the Health Promotion Administration said yesterday.
Given that the incidence of colon cancer among younger Taiwanese has spiked to higher than its counterparts in the UK, the US, Japan and South Korea, free screenings would be expanded to cover people aged 45 to 49, in addition to those aged 50 to 74, starting from this year, Cancer Prevention and Control Division Director Lin Li-ju (林莉茹) said.
Photo courtesy of the Health Promotion Administration
People aged 40 to 44 who have parents, children or siblings diagnosed with colon cancer would also be included, she said.
They could have a fecal occult blood test once every two years, Lin said, adding that periodic screening could reduce the incidence of advanced colon cancer by 29 percent and the mortality rate by 35 percent.
Of people who test positive, one in two has colon polyps and one in 20 has colon cancer, she said, adding that those who do not have a colonoscopy for further screening would have an additional mortality risk of 64 percent.
To prevent the disease, people should increase their intake of water, fruit and vegetables, and reduce oils, salts, red meat and sauce in their diet, while removing meat skin, fat and charred food, Lin said, adding that exercise is also important.
In Taiwan, colon cancer is the second-most common type of cancer, with 17,643 additional patients in 2022, equivalent to a person catching the disease every 29 minutes and 47 seconds, and a death every 77 minutes and 24 seconds, she said.
The median onset age was 67, while the median death age was 73, Lin said. The goal is to decrease cancer mortality rates by one-third by 2030, in line with the “Healthy Taiwan” policy, she said.
Data show that the colon cancer incidence rate for people aged 50 to 59 declined between 2010 and 2018, National Taiwan University Hospital clinical professor of internal medicine and colorectal cancer screening project leader Chiu Han-mo (邱瀚模) said.
However, the incidence rate for people aged 40 to 44 rose from 21 to 29.8 people per 100,000, while the rate for those aged 45 to 49 increased from 40.4 to 49.8 per 100,000 people, he said.
Data from 2020 showed the colon cancer incidence rate in Taiwan for men was 43.12 per 100,000 and 29.31 per 100,000 for women. The rates for both genders were higher than those of the US, the UK, Australia, Japan, South Korea and Singapore, Chiu said.
Although the incidence of early onset colon cancer is rising globally, Taiwan is among the worst and should review the disease’s risk factors and implement screenings, he said.
People aged 50 or younger with colon cancer increased from 1,871 people in 2012 to 2,049 people in 2022, with 24.1 percent of them diagnosed as phase I colon cancer and 22.7 percent as phase IV, Society of Colon and Rectal Surgeons deputy secretary-general Chang Chu-cheng (張巨成) said.
Most people diagnosed as phase I are more aware of their physical conditions and would go to see a doctor when feeling unwell, while those diagnosed as phase IV are usually not, he said.
The five-year survival rates for people aged 50 or younger with colon cancer at phase I, II, III and IV are 97.2 percent, 96.9 percent, 77.5 percent and 22.6 percent respectively, all higher than those of people aged 65 or older at 84.8 percent, 76.8 percent, 68.3 percent and 13.9 percent respectively, Chang said.
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