UICC World Cancer Congress 2006

In 2002, there are 63,737 newly diagnosed cancer patients were reported to Taiwan Cancer Registry System. Of these new cases, 3,709 are oral cancer patients, its crude incidence is 16.47/105, and the age-standardized incidence rate is 15.19/105. Oral cancer has become the 4th ranking cancer among all sites of cancer in men, but is the first leading type of cancer diagnosed among men between 25 to 44 years of age.

Oral cancer is the kind of cancer of which precancerous lesion can be seen by naked eyes, and the cost-effectiveness of oral cancer screening has been suggested by World Health Organization. In Taiwan, the Department of Health and local health authorities have been working together since 2000 to provide free oral mucosa checkups to both smokers and areca/betel quid chewers, with the help of dental and ENT clinicians.

During these five years we implemented our services program, due to our efforts, the number of smokers/chewers being screened increased sharply. Altogether more then 1.12 million chewers/smokers participated in our program. Of these smokers/chewers being screened, 1.3% was initially found to have positive findings, followed by 64.6% follow-up rate, and 1,152 with confirmed diagnosis. With the experience implementing the program, the follow-up rate kept increasing, in first year it was around 20%, while in the fifth year, it soared to above 90%.

Currently, oral cancer screening in Taiwan has been provided in Community-based Integrated Screening organized by local health authorities, and its cost-effectiveness has been revealed. With an economic evaluation performed in 2004, we found that, the percentage of abstinence from smoking/chewing in those screened positive is significantly higher than in those screened negative. Also, the incremental cost-effectiveness ratios for annual regime, five-yearly regime, 10-yearly regime for those who were screened positive against those who were screened negative were calculated as $21.59, $36.34, $5.32 per life year gained.