Background: Malignant tumors are the leading cause of death in Taoyuan City. Currently, in all types of female cancer, the average ages of onset for breast cancer and cervical cancer are 53.6 and 57.1 years of age, and their incidence rates came first and seventh of all cancer types in Taoyuan, respectively. Primary screening using mammography and pap smear test are proven to be effective in finding asymptomatic patients of these two types of cancer. Early detection and treatment can prevent late-stage cancer at an older age and poor recovery. Hence, to promote cancer screening for women, Taoyuan City started providing annual pap smear test for women over 30 years of age since 1995, and bi-annual mammography for women between the age of 45 and 69 since 2004.
Methods: Multiple strategies for regular screening notification for female citizens:
- In 2017, all female citizens between the age 30 and 69, who had not undergone pap smear test for 3 years or more, and all female citizens between the age 45 and 47, who had not undergone mammography were sent a letter of invitation, which provided relevant information regarding screening facilities and the conveyed the importance of regular screening.
- Mobile phone notification message system for screening was created. Female citizens who had not undergone screening were sent a notification through SMS (Short Message Service) regarding the recent screening service in their community to increase screening accessibility.
- Quarterly lottery is held to encourage female citizens to undergo screening. In each quarter, female citizens who underwent cancer screening were listed, and winners were drawn randomly from the list. Fifty 1,000 NTD coupon and one 5,500 NTD coupon were given out each quarter.
Screening events were promoted and community screening rate was increased by the aforementioned methods.
Results: We have analyzed the screening events in 2017 in Taoyuan City. The number of screening for those who had not undergone pap smear test for three years or more had an increase of 5,017 (9.46%) compared to 2016. The percentage of those who had undergone pap smear test in the past two years was 64.94%. The number of mammography had an increase of 6,651 (10.29%) compared to 2016. The percentage of those who had undergone regular screening in the past five years was 66.07%.
Conclusion: Long-term implementation of multiple interventional strategies to encourage regular female cancer screening had lowered the standardized incidence rate of cervical cancer from 30.6 per 100,000 persons in 1998 to 10.5 per 100,000 persons in 2014. Standardized mortality rate was also lowered from 11.5 to 3.6 per 100,000 persons. Although the standardized incidence of breast cancer had increased from 43.5 per 100,000 persons in 2004 to 75.0 per 100,000 persons in 2014, the standardized mortality rate due to breast cancer had decreased from 12.9 to 11.2 per 100,000 persons in the past three years.