Managing the transition in cervical screening methods for Taiwan: Policy recommendations and perspectives

Chien-Chin Chen; Chyong-Huey Lai; Chih-Long Chang; Wen-Fang Cheng; Raoh-Fang Pwu; Jane Tsai; Peng-Hui Wang; Jacqueline Whang-Peng; Gi-Ming Lai

doi:10.1016/j.jfma.2023.06.018

Managing the transition in cervical screening methods for Taiwan: Policy recommendations and perspectives

J Formos Med Assoc. 2023 Nov;122(11):1213-1218. doi: 10.1016/j.jfma.2023.06.018. Epub 2023 Jul 12.

Authors

Chien-Chin Chen¹, Chyong-Huey Lai², Chih-Long Chang³, Wen-Fang Cheng⁴, Raoh-Fang Pwu⁵, Jane Tsai⁶, Peng-Hui Wang⁷, Jacqueline Whang-Peng⁶, Gi-Ming Lai⁸

Affiliations

¹ Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, 600, Taiwan; Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, 717, Taiwan; Ph.D. Program in Translational Medicine, Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, 402, Taiwan; Department of Biotechnology and Bioindustry Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan, 701, Taiwan.
² Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, 333, Taiwan; Chang Gung University, Taoyuan, 333, Taiwan.
³ Department of Medicine, MacKay Medical College, New Taipei City, 252 Taiwan; Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, 104, Taiwan.
⁴ Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, 100, Taiwan.
⁵ School of Health Care Administration, Taipei Medical University, Taipei, 110, Taiwan; Data Science Center, Fu Jen Catholic University, New Taipei City, 242, Taiwan.
⁶ Formosa Cancer Foundation, Taipei, 105, Taiwan.
⁷ Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, 112, Taiwan; National Yang Ming Chiao Tung University, Taipei, 112, Taiwan.
⁸ Formosa Cancer Foundation, Taipei, 105, Taiwan. Electronic address: gminlai@canceraway.org.tw.

PMID: 37451959
DOI: 10.1016/j.jfma.2023.06.018

Abstract

Since government-provided annual cervical cytology testing for all Taiwanese women aged 30 years or older became available in 1995, both cervical cancer incidence and death have decreased significantly. However, with the 2018 introduction of the national immunization program for human papillomavirus (HPV) vaccination in all schoolgirls aged 13-15 years old, the positive predictive value of cytology testing is expected to decrease with rising vaccination rates, and therefore a transition to more sensitive HPV-based testing may be needed. This position paper, derived from discussions by a panel of experts in cervical cancer screening, provides short-, medium-, and long-term policy recommendations to manage the transition between cervical screening methods for Taiwan. The recommendations include concrete suggestions regarding testing procedures, standards, accreditation, monitoring, promotion, and implementation. It is hoped that comprehensive preparation and management of this transition will enable Taiwan to repeat the previous successes of the cervical cytology testing program.

Keywords: Cervical cancer; Cervical cytology; HPV-based testing; Human papillomavirus; Pap smear.

MeSH terms

Adolescent
Early Detection of Cancer
Female
Humans
Mass Screening
Papillomavirus Infections* / diagnosis
Papillomavirus Infections* / epidemiology
Papillomavirus Infections* / prevention & control
Policy
Taiwan
Uterine Cervical Neoplasms* / diagnosis
Uterine Cervical Neoplasms* / prevention & control
Vaginal Smears