“The moment a screened individual expresses their gratitude to us, a deep sense of accomplishment emerges. It's then that we truly realize we are doing something meaningful—not reacting after an issue arises, but taking preventive action beforehand,” said Hsu Tsen-Tiao, Project Assistant of the Health Promotion Section at the Department of Public Health, Taoyuan City Government, following the results presentation for the Expanded Lung Cancer Screening Program.
According to statistics from the Ministry of Health and Welfare, lung cancer ranks first in cancer mortality and second in cancer incidence both nationally and in Taoyuan City. As an industrial hub frequently affected by air pollution, Taoyuan City launched the Expanded Lung Cancer Screening Program in 2023 to better safeguard residents' health. The program targets residents registered in Taoyuan who are over 40 years old and belong to one of four high-risk categories: tobacco exposure, relevant medical and family history, occupational exposure, and air pollution or cooking oil fumes. Eligible individuals are provided with low-dose computed tomography (LDCT) chest scans for lung cancer screening. By the end of 2023, a total of 18,514 individuals had undergone lung cancer screening, resulting in the diagnosis of 107 cases of lung cancer. This initiative has potentially saved over 100 families from the burdens of disease and caregiving, offering them a chance at improved health and well-being.
Expanding Subsidy Eligibility to Protect Public Health
Since July 1, 2022, the Health Promotion Administration of the Ministry of Health and Welfare has implemented an early detection program for lung cancer. This program provides low-dose computed tomography (LDCT) lung cancer screenings every two years for high-risk groups, such as heavy smokers or those with a family history of lung cancer. Hsu Tsen-Tiao, along with the Public Health Department team, shared: “The current subsidies provided by the Health Promotion Administration do not include groups affected by air pollution industries or regions. However, numerous studies indicate that air pollution is a significant risk factor. Taoyuan, being an industrial hub, prompted us to expand the screening criteria to include 'occupational exposure' and 'air pollution and cooking oil fumes' as part of the eligible groups to better protect our citizens' health.”
Pioneering an Online Screening Reservation System to Enhance Administrative Efficiency
“When the Health Promotion Administration initially launched the program, individuals had to book appointments by phone, fill out paperwork on-site, and have their identity verified in person. For elderly citizens with limited mobility, this process could take 20–30 minutes, not including waiting times. Often, individuals would complete the paperwork only to find out they were ineligible, resulting in unnecessary trips,” explained Hsu Tsen-Tiao. To streamline the process and reduce the administrative burden, especially for the elderly, Hsu and the Public Health Department team introduced an online reservation system. Eligible individuals can access the Lung Cancer Screening Reservation Platform on the department's website to submit their applications online. The review process takes only three business days, and once approved, individuals receive a QR code that they can present at their designated hospital to complete the screening.
This innovative system eliminates the need for paper forms and lengthy on-site procedures, saving time and improving the overall efficiency of the lung cancer screening program.
Harnessing AI Technology: Artificial Intelligence-Assisted Image Interpretation
“When we first convened an expert meeting with our partner medical institutions, we set a target to subsidize 25,000 individuals for screening. For hospitals, this meant an abrupt increase of 25,000 CT scans to interpret. Unlike traditional X-rays, CT scans provide 360-degree imaging for each individual, resulting in 400–500 images per person that need to be analyzed,” explained Hsu Tsen-Tiao. To alleviate the burden on medical professionals, the Public Health Department subsidized the implementation of AI-assisted image interpretation technology in hospitals. This AI technology aids physicians by identifying lesions that may be too subtle for the naked eye to detect. Hsu highlighted that AI-assisted interpretation reduces reading time by approximately 20%, increases the positive case detection rate by 14%, and significantly enhances imaging efficiency. This technology minimizes errors from manual interpretation, improves screening sensitivity, and shortens the waiting time for screening results. These advancements provide citizens with higher-quality health services and a more efficient lung cancer screening process.
Health is a Collective Responsibility
“Since March 2023, we have continuously expanded the target groups for screening. This effort stems from the fact that many eligible residents have not yet taken the initiative to get screened. We urge citizens to recognize that health is something you must actively pursue and protect. With the city government providing this service, we encourage everyone to participate in the screening process actively,” said Hsu Tsen-Tiao. Together with the Department of Public Health team, Hsu has gradually expanded the target screening groups based on field investigations, feedback from experts, scholars, and citizens, as well as actual screening outcomes. In March 2024, the program included additional groups, such as women with second-degree relatives diagnosed with breast cancer within the past 10 years, and individuals who have worked for over 10 years in any of the 43 industrial parks. The department is also considering including high-risk groups aged 40 and above residing near large power plants and incinerators in future expansions, aiming to safeguard the health of an even broader segment of the community.