The geo-political entity of Taiwan includes Taiwan island proper, Penghu (Pescadore Islands), Kinmen, Matsu, and dozens of other small islands. Taiwan is situated on the northeastern edge of the Pacific Ocean, approximately 160 km off the southeastern coast of the Chinese mainland. Located midway between Korea and Japan to the north and Philippines to the south at latitude 24oN and longitude 121oE Taiwan and the adjacent islands have an area of approximately 36,000 km2. Household registration has been implemented in Taiwan since 1906. Information is recorded mandatorily and double-checks performed annually by household registration officers. It is considered quite complete and accurate. At the end of 2002, the total population of Taiwan was 22,520,776.
The island of Taiwan is approximately 394 km long and 144 km at its widest point. Taiwan's climate is subtropical in the north and tropical in the south, with temperatures ranging from 28o to 35o C in July and 8o to 16o C in January. It is generally hot and humid in the summer. The average rainfall is 2,515 mm per year.
Cancer care facilities
General health care in Taiwan is provided predominantly by private practitioners and private and public hospitals. Most cancer patients are diagnosed and treated in hospitals with 50 or more beds. The island nation has implemented a national health insurance programme since March 1995 with an overall coverage of 99% of the population. Diagnosis and treatment of cancer is covered by the national health insurance. As far as cancer treatment is concerned, all major medical centres have oncology departments and the specialty of oncology requires board certification. There are ten major medical centres and one comprehensive cancer hospital in Taiwan. Hundreds of regional and district general hospitals are also actively involved in cancer diagnosis and treatment. Among 31,532 physicians and surgeons in Taiwan, there are 170 medical oncologists.
Registry structure and methods
The Taiwan Cancer Registry, a population-based cancer registry, was founded in 1979. Hospitals with greater than 50-bed capacity which provide outpatient and hospitalized cancer care are recruited to participate in reporting all newly diagnosed malignant neoplasms to the registry.
The registry is organized and funded by the Department (Ministry) of Health of the executive branch of the central government. The National Public Health Association has been contracted to operate the registry and organized an advisory board to standardize definitions of terminology, coding, and procedures of the registry's reporting system. A professor of epidemiology heads the registry. The full-time staff members of the registry include a research fellow in cancer epidemiology and eight cancer registrars. The registry is assisted by a Cancer Registry Advisory Board, comprising 16 expert members from various fields such as pathology, clinical oncology, radiation oncology, cancer registrar, and public health. The data are collected and stored in computers. Duplicate checks and quality controls are run periodically to detect possible mistakes and inconsistencies.
Interpreting the results
A nationwide hepatitis B vaccination programme since 1984 has shown early signs of success in prevention of liver cancer in Taiwan. Annual cervico-vaginal smears for cervical cancer screening are paid for by the national health insurance. In the 1998-2002 period, 4,381,240 women had at least one Pap smear. Project-based free screening for liver, colorectal, female breast, and oral cancer among high-risk groups has been included in the Department (Ministry) of Taiwan Multicentre Cancer Screening (TAMCAS) project since 1992.
Use of the data
The registry's primary goal is to survey the incidence of cancer in Taiwan. It also participates in planning and evaluation of cancer control and prevention programmes. Cancer incidence data appear each year in a special bulletin and in an annual registry report published by the Ministry of Health. Analyses and observed trends are published in annual reports or in medical journals. The registry also provides a database regarding cancer for various research efforts.