Presentation on theme: "Cancer Prevention in Taiwan"— Presentation transcript:
1 Cancer Prevention in Taiwan Bureau of Health PromotionDepartment of HealthTaiwan
2 The Statistics of Cancer the first leading cause of death since 1982Crude incidence 265/105 (59,116), 2000Crude mortality 141/105 (31,554), 2000Direct medical cost : $ 0.7 billion dollars annually (NHI), 2002
10 Proportion of CIS and Invasive Ca Cervical cancer (1992-1998) yearIn-situ CaCase No.（%）Invasive Ca19921,060（31.1）2,350（68.9）1993971（29.8）2,291（70.2）19941,169（35.2）2,150（64.8）19951,297（35.9）2,312（64.1）19961,987（43.3）2,601（56.7）19972,409（48.3）2,575（51.7）19983,095（52.5）2,796（47.5）
11 Priorities and strategies for cancer Prevention PrimaryScreenCurativeTxPalliativeCareLung＋＋－Stomach＋BreastColorectalCervixOralpharynxLiver
12 Future Burden of Cancer ( 2020 ) Cancer mortality will continue to increase; The number of new cancer cases per year will increase to 100,000 (from 60,000).Incidence of all cancers will increase to 410/105 (from 265/105).
14 Goals of NCCPTo slow down the increase of the age-adjusted mortality rate of all cancers, especially breast cancer, oral cancer and colon-rectum cancer.To reduce the age-adjusted mortality rate of cervical cancer to 3.9/105; to reduce the proportion of invasive cervical cancer to all cervical cancer to 35%.;To increase the male five-year survival rate of all cancers by 1%; to increase the female five-year survival rate of all cancers by 2%;To improve the approval rate of patients for the medical care of cancer.
15 Objectives of NCCP 17.5％ 17％ 74.8％ 80％ 55.6％ 60％ 2.8％ 20％ 19.9％ 35％ Itemized Goals20032009Improve the public’s anti-cancer capabilitiesSmoking ratesee Tobacco Hazards Control PlanBetel nut chewing rate (male adults)17.5％17％Obese populationsee National Nutrition Improvement ProgramImprove coverage rates of major cancer screeningsCervical cancer (women 30-69)74.8％80％(three-year screening rate forwomen 30-69)55.6％60％Breast cancer (women 50-69)2.8％20％Oral cavity cancer (smoking or betel nut chewing persons 20 and above)19.9％35％Colon-rectum cancer (general public 50-69)1.3％30％
16 Strategy 1 Building Healthy Lifestyles & Reducing Risks of Cancer Promotion of tobacco hazards control planPromotion of betel nut hazards controlPromotion of cancer prevention dietPromotion of hepatitis controlPromotion of HPV prevention and control plan
17 Promotion of Betel Nut Hazards Control To recommend practicable plans for the control and taxation of betel nut; to establish legal sources and financial basis for the control of betel nut;To build up partnership for the control of betel nut hazards; to develop NGOs;To continue to supervise betel nut managers to label health warnings on packs;To strengthen education through mass media on betel nut hazards, and to conduct preventive intervention projects among specific groups (schools, worksites, army, and communities of high betel nut use).
18 Promotion of HPV Prevention and Control Plan To improve the public’s awareness of the relationship between HPV and cervical cancer; to promote safe sexual behavior;To set up epidemiological data on HPV infection in Taiwan and also KAP data of women on HPV;To participate in international HPV vaccine development research; to recommend the promotion of immunization programs.
19 Strategy 2 Promotion of Cancer Screening for Early Detection and Early Treatment Establishing evidence-based screening models;Including screening in the health promotion services of the National Health Insurance;Improving alertness to the early symptoms of some common cancers;Reducing obstacles; improving coverage rate of screening;Establishing an effective referral and follow-up system for positive cases;Establishing a quality monitoring system for screening;Establishing databanks of screening.
20 Cancer Screening Programs TargetPolicyThe year of beginningCervical cancerWomen aged 30 and abovePap smear (once/year)1990 (BHP)July 1995 (NHI)Breast cancerHigh-risk women aged 50-69Mammography (once/year for women with family history; once every three years for other high-risk women)July 2002 (BHP)Oral cancerSmoking or betel nut chewing persons aged 18 and aboveExamination of oral cavity mucus (once/3 years)1999 (BHP)Colon-rectum cancerGeneral public agedFOBT(once/year)July 2003 (BHP)Liver cancerBy findings of liver cancer screenings, to conduct abdominal ultra-sound screening for hepatitis B carriers for persons 40 and above.
21 Strategy 3 To improve hospital accountability To promote evidence-based medicine consensus on the diagnosis and treatment of cancer;To realize management of cancer diagnosis and treatment in hospitals, and to upgrade quality, safety, and “patient-oriented” medical care servicesTo establish an assessment system for the medical care of cancerTo make cancer care hospitals improve their quality; to make hospitals set up a mechanism for the realization of cancer care management.
22 Strategy 4 To Consolidate and mobilize Community Resources for preventive and supportive Services To support cancer-related public-interest civic groups, and to establish a collaborative mechanism between governmental and NGOs;To overall plan the allocation of service resources and contents to meet the needs of the target population.
23 Strategy 5 To Promote Hospice Care and Improve the Quality of Life of Patients To promote education to make people understand the meaning of hospice care;To set up a hospice care network accessible to those in need;To improve the quality of hospice care;To train cancer care-associated medical personnel in hospice care;To develop different reasonable payment schedules for hospice care.
24 Strategy 6 To Establish Cancer Databanks, to Continue to Monitor and Assess the Cancer Control Plan To establish and manage cancer control- associated databanks;To set up a quality improvement mechanism for the reporting of cancer informationTo set up a cancer control information management center; to publish major information.
25 Strategy 7 To Consolidate Cancer Research through a Cancer Research Center To set up by regulations a cancer research center in the National Health Research Institutes to formulate national research and development directions for cancer, and to consolidate research resources;To promote the “three-step five-level” research of cancer;To plan for the establishment of a research utilization mechanism and a feedback to policy making mechanism.
26 Strategy 8 To Establish a Long-Term Manpower Development Policy To regulate qualifications of service providers;To assess the manpower demands and current supply;To provide on-job training and advanced training overseas;To supervise relevant medical associations to set up professional licensure systems for special demands of cancer care;To include communication skills, and concepts of holistic care and hospice in the education.
27 Budget and human resources in our division There are currently 17 members in our division, one chief, one senior executive officer, other are distributed in three sections.In year 2005, we will invest about 14 million dollars in cancer control (if the five-year program is approved, there will be 115 million dollars invested).