Breast Cancer Trend in Taiwan

Abstract

Breast cancer is the most common cancer among women, according to the cancer registration report of the Ministry of Health and Welfare (MOHW), in 2014,1 up to 11,976 women suffered from breast cancer, which meant 33 women suffered from breast cancer daily. The latest statistical data revealed that, in Taiwan, the ranking of breast cancer and cervical cancer incidence rate in 2014 were the top (70.74 per 100,000 population) and the eighth (8.5 per 100,000 population), respectively; while compared with the incident numbers in 2013,2 they were 695 cases in addition and 127 cases in decline, respectively; when it comes to incidence rate, it was 2% increased and 10% declined, respectively. The number of breast cancer increased more significantly. In 2014, the mortality rate of breast cancer ranked the fourth, the death toll was 2,071, which means around 5.67 women died from breast cancer each day. Due to the westernized lifestyle and dietary habits, the age of breast cancer onset in Taiwan gets younger (Figure 1), and is about 10 years younger than that in the western countries. According to the statistics (Figure 2), the rate of early stage (stages 0-2) breast cancer cases diagnosed by screening was 86%, whereas the rate of those not diagnosed by screening was 56%. Regular screening assists in recognizing early stage of breast cancer, and early treatment increases the remission rate, therefore, the five-year survival rate of screened patients reached higher than 90%, whereas the five-year survival rate of unscreened patients suffered from breast cancer diagnosed at late stage (stage 4) was only 27.8%. Mammography is the process of using low-energy X-rays (about 0.7 mSv) to examine human breast for screening calcification and stage 0 (carcinoma in situ) of breast cancer.3 A randomized trial with large scale mammography screening of breast cancer in 1977 has adopted the spilt screen design with inviting one group for periodical mammography while the other group was not invited. When the trial was ended in 1985, the controlled group was provided with one screening to balance the prevalence screening cases of screening group and lessen bias. After following up for several years, it showed a significant difference in mortality rate. The mortality rate of breast cancer in women with periodical screening declines up to 30 percent.4 Nowadays, according to the medical evidence, the western countries promote large scale screening services for women as well as subsidies of breast x-ray once every two years for patients aged 45-69 or patients aged 40-44 with family history of breast cancer (which means anyone of the patient’s grandmothers, mother, daughter(s) or sister(s) has ever suffered from breast cancer) to protect the health of women’s breasts.