Cancer Registry
Not too long ago the main cause of death affecting the general public in Taiwan was
infectious diseases. Today we find that this is no longer the case.
Over the years we have
made considerable progress in the application of new medical and pharmaceutical
technologies. Also, Government funded public education has resulted in many choosing life
styles that have reduced the risk of infectious disease. Today, death and disability more
often arise from accidents, injuries and chronic diseases, and our focus has had to turn from
disease treatment to health promotion.
Of the ten major causes of death in Taiwan, cancer
had already risen to the number one position by 1982.
This trend has continued and now the
incidence of death caused by cancer is alarming, as such effective cancer control is one of the
most important current public health challenges.
In order to effectively gain control of the current cancer situation, the Department of
Health, Executive Yuan, Taiwan, began in 1979 to establish the National Cancer Patient
Database, which collects cancer registry information from hospitals, with more than fifty
beds occupied. The database collects patients’ basic information, the date of last contact,
place of birth, age upon cancer diagnosis, household registration number, cancer type,
histopathological observations, cancer stage or differentiation, diagnosis reference, date of
initial diagnosis, treatment, treatment out of hospital, cause and date of death etc. The Bureau
of Health Promotion publishes an annual report from the cancer registry every year. This
report, in addition to providing a reference for health institutions to enact cancer control
policies, has become an important resource for academic institutions to carry out
epidemiologic researches, in order to study the risk factors and disease evaluation.
In
addition the bureau also publishes CD-ROMs and makes cancer related information available
on the Internet, allowing the public to search for information from the cancer registry.
In 2001, new cancer cases were reported by a total of 194 hospitals, which had more
than 50 beds, and after comparison and then ruling out duplicate cases, there were 61,607
cases of cancer (including original cancer cases) (male 33,157, female 28,450). There were
2,491 new cases, compared to the level recorded in 2000. Please see details of information
relating to the cancer registry in the appendixes.
106752950
1
Appendix
2001 Cancer Registry Report
1.
In 2001, new cancer cases were reported by a total of 194 hospitals, which had more
than 50 beds, and after comparison and then screening out duplicates, there were
61,607 cases of cancer (including original cancer cases) (male 33,157, female
28,450). There were 2,491 new cases, compared to 2000. Moreover, after the data
gained by cancer registration covered major symptoms and diseases as well as
information on death in Taiwan, the completeness and accuracy reached 95% and
98.9% respectively. These are both are in line with the criteria (90%, 95%) set up
by the North American Association of Central Cancer Registries.
2.
The crude cancer incidence rate in 2001 was 274.96 per one hundred thousand
populations, of which male and female came to 289.79 and 259.49 per one hundred
thousand persons respectively. The total cancer age-standardized incidence rate is
261.13 per one hundred thousand persons, of which male and female are respectively
278.02 and 243.41 per one hundred thousand persons. The crude cancer incidence
rate and cancer age-standardized incidence rate are higher than those in 2000 (See
appendix 1).
3.
In 2001, males most frequently suffered cancers of the five major organs:
(1) Liver and bile duct;
(2) Lungs, trachea and bronchus;
(3) Colon and rectum;
(4) Oral cavity (include mouth, pharynx and lower pharynx); and
(5) Stomach.
Females most frequently suffered the following cancers:
(1) Cervical (include in situ carcinoma);
(2) Breast;
(3) Colon and rectal;
(4) Liver and bile duct:
(5) Lungs, trachea and bronchus (See appendix 2).
106752950
2
4.
Males and females have different organs predisposed to the disease so their total
cancer survival rates are different. The female five-year survival rate of total cancers
(in situ carcinoma not included) is 57.84%, which is far higher than that of males,
32.35%.
5.
Comparing the age-standardized incidence rate of cancers in recent five years
(1997-2001), the rate of invasive cervical cancer declined the most dramatically
(↓21.30%), indicating that early cervical smear testing is very effective. Other
cancers that also have declined in age-standardized incidence rate include female
gastric cancer (↓13.62%) and male nasopharyngeal carcinoma (↓6.56%). Cancers
showing increases greater than 10% of the age-standardized incidence rate for males
include those of the oral cavity (↑29.40%), esophagus (↑27.08%), skin (↑21.99%),
prostate (↑20.84%), colon and rectum (↑16.31%), liver (↑15.14%) and bladder
(↑13.29%). For females cancers showing similar increases include those of the
womb (↑26.86%), breast (↑23.97%), liver (↑21.19%), skin (↑16.91%), lung
(↑13.42%), colon and rectum (↑12.34%) and. thyroid adenoma (↑22.96%).
To improve the completeness and accuracy of cancer registry data, the Bureau of Health
Promotion, Department of Health, launched the following measures in 2004:
(1) Serious symptoms or diseased case files are to be forwarded to hospitals, which are
required to confirm and report cases for cancer registry; because of this, the comprehensive
nature of registry data has increased from 85% in 1996 to 95% in 2001;
(2) Four basic staff training sessions on the cancer registry have been held to train
cancer registry staff to a high level in order to increase the quality of the cancer registry. The
first examination for qualifications for cancer registry staff were held on 19 December 2004
(to
register
for
the
examination,
please
see
information
online:
http://w3.sce.pccu.edu.tw/health), which has been included in hospital evaluations in 2005;
(3) Case histories should be re-checked to increase the accuracy of the data reported.
Aware of the threat of cancer to the citizens of Taiwan, the government announced
cancer prevention regulations on 21 May 2003. This was in order to integrate resources of
medical treatment and health prevention, and effectively carry out the work of cancer
prevention. A five-year cancer prevention plan has been drawn up for approval by the
Executive Yuan, Taiwan, in the hope of lowering the death rate from cancer in Taiwan.
Currently, the five-year cancer prevention plan drawn up by the Department of Health is
mainly concerned with:
(1) Creation of an integrated cancer prevention framework,
106752950
3
(2) Encouragement of a healthy life style for people to lower their risk factors for various
cancers,
(3) Carrying out cancer screening for early diagnosis and treatment,
(4) Establishing the practice of cancer management in hospitals to ensure the quality of
diagnosis and treatment,
(5) Actively carrying out gentle and moderate treatment to increase patients’ quality of
life,
(6) Establishing a cancer prevention database and continuously monitoring and
evaluating the cancer prevention plan,
(7) Integrating and performing relevant cancer research, and
(8) Professional training.
106752950
4
Appendix 1: Comparison of 2000 and 2001 Cancer Occurrence Information
2001
Year
Item
Male
2000
Female
Male
Female
Case Number (patient)
Age Mediam Number
Crude Incidence Rate (105)
Age-standardized incidence rate (105)
Gender Ratio
Appendix 2-1: The Incidence Rate of Ten Major Cancer in 2001
Increase or decrease
of Age-Standardized
Crude
Incidence Rate
Age-Standardized Age-Standardized
Incidence
between 2001 and
Incidence Rate
Incidence Rate
Rate
2000 (%)
2001
Cancer Position
Case
Number
2000
Cervical Cancer
In Situ Carcinoma
Invasive Cancer
Female Breast
Liver and Bile Duct
Colon and Rectum
Lungs, trachea and
bronchus
Prostate Gland
Oral Cavity (mouth,
pharynx and lower
pharynx)
Stomach
Skin
Bladder
Other Positions
Total
Note 1: World standard population in 2000 is used as the standard population in the calculation of
age-standardized incidence rate.
Note 2: Percentage of increase or decrease = (year 2001 age-standardized incidence rate – year 2000
age-standardized incidence rate)/ year 2000 age-standardized incidence rate
Note 3: The unit is per one hundred thousand populations
106752950
5
Appendix 2: The Incidence Rate of Male Ten Major Cancers in Taiwan in 2001
Increase or decrease
of Age-Standardized
Crude
Incidence Rate
Age-Standardized Age-Standardized
Incidence
between 2001 and
Incidence Rate
Incidence Rate
Rate
2000 (%)
2001
Cancer Position
Case
Number
2000
Liver and Bile Duct
Lungs, trachea and
bronchus
Colon and Rectum
Oral Cavity (mouth,
pharynx and lower
pharynx)
Stomach
Prostate Gland
Bladder
esophagus
Skin
Nose and Pharynx
Other Positions
Total
106752950
6
Appendix 203: The Incidence Rate of Female Ten Major Cancers in Taiwan in 2001
2001
Cancer Position
Case
Number
Crude
Age-Standardized
Incidence
Incidence Rate
Rate
2000
Case Number
Increase or decrease
of Age-Standardized
Incidence Rate
between 2001 and
2000 (%)
Cervical Cancer
In Situ Carcinoma
Invasive Cancer
Female Breast
Colon and Rectum
Liver and Bile Duct
Lungs, Trachea and
Bronchus
Stomach
Skin
Thyroid gland
Ovary, Fallopian
tube and Wide
Ligament
Womb
Other Positions
Total
Note 1: World standard population in 2000 is used as the standard population in the calculation of
age-standardized incidence rate.
Note 2: Percentage of increase or decrease = (year 2001 age-standardized incidence rate – year 2000
age-standardized incidence rate)/ year 2000 age-standardized incidence rate
Note 3: The unit is per one hundred thousand populations
106752950
7