Lobectomy numbers have not risen significantly, the Ministry of Health and Welfare said on Wednesday in response to reports that the government’s lung cancer screening program has led to overdiagnosis.
Since 2022, the ministry’s Health Promotion Administration (HPA) has offered free low-dose computed tomography (LDCT) screening for heavy smokers and people with a family history of lung cancer, making Taiwan the first country in the world to do so.
However, in an opinion piece published by a local media outlet earlier this month, Wayne Gao (高志文), a professor at Taipei Medical University’s College of Public Health, said that the widespread use of free LDCT screening has led to lung cancer overdiagnosis in Taiwan.
Photo: Lin Hui-chin, Taipei Times
Gao said the use of LDCT screenings over the past 10 years has subjected many people to “unnecessary” lobectomies.
Chen Lian-yu (陳亮妤), head of the National Health Insurance Administration (NHIA), said that NHIA data show the number of people undergoing lung-related resection surgery rose only 2 percent from 21,309 in 2023 to 21,753 last year.
Types of lung resection surgeries include lobectomy, segmentectomy and wedge resection.
From 2023 to last year, the annual number of patients undergoing lobectomies increased from 4,161 to 4,311, according to NHIA data.
Segmentectomy cases rose by 553 and wedge resections fell by 259, according to NHIA estimates.
LDCT screening has been promoted for three years, but the number of surgeries has not shown a significant deviation, Chen said.
The number of lobectomy cases, which has drawn the most public attention because it involves the removal of a lung lobe, stands at about 4,000 annually and is “quite stable,” she added.
Addressing concerns about overdiagnosis and unnecessary surgery, Chen said that last year, more than 92 percent of the 21,753 patients who underwent lung-related resection surgery held Major Illness/Injury Certificates for lung cancer, a relatively high ratio.
For hospitals seeing a higher volume of surgeries where the final diagnosis turns out not to be lung cancer, Chen added that the NHIA has stepped in to help review and guide their surgical practices.
In the future, the NHIA would compare data with the HPA to better track the subsequent treatment of people who test positive in LDCT screening, Chen said.
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