Performance measures of 8,169,869 examinations in the National Breast Cancer Screening Program in Taiwan, 2004-2020.

BACKGROUND: The benefits of mammographic screening have been shown to include a decrease in mortality due to breast cancer. Taiwan's Breast Cancer Screening Program is a national screening program that has offered biennial mammographic breast cancer screening for women aged 50-69 years since 2004 and for those aged 45-69 years since 2009, with the implementation of mobile units in 2010. The purpose of this study was to compare the performance results of the program with changes in the previous (2004-2009) and latter (2010-2020) periods. METHODS: A cohort of 3,665,078 women who underwent biennial breast cancer mammography screenings from 2004 to 2020 was conducted, and data were obtained from the Health Promotion Administration, Ministry of Health and Welfare of Taiwan. We compared the participation of screened women and survival rates from breast cancer in the earlier and latter periods across national breast cancer screening programs. RESULTS: Among 3,665,078 women who underwent 8,169,869 examinations in the study population, the screened population increased from 3.9% in 2004 to 40% in 2019. The mean cancer detection rate was 4.76 and 4.08 cancers per 1000 screening mammograms in the earlier (2004-2009) and latter (2010-2020) periods, respectively. The 10-year survival rate increased from 89.68% in the early period to 97.33% in the latter period. The mean recall rate was 9.90% (95% CI: 9.83-9.97%) in the early period and decreased to 8.15% (95%CI, 8.13-8.17%) in the latter period. CONCLUSIONS: The evolution of breast cancer screening in Taiwan has yielded favorable outcomes by increasing the screening population, increasing the 10-year survival rate, and reducing the recall rate through the participation of young women, the implementation of a mobile unit service and quality assurance program, thereby providing historical evidence to policy makers to plan future needs.

Demands for medical imaging and workforce Size: A nationwide population-based Study, 2000-2020.

PURPOSE: The aim of this study was to investigate associations between workforce and workload among radiologists in Taiwan. MATERIALS AND METHODS: Data for the period 2000-2020 describing the demand for imaging services and radiologists have been obtained from databases and statistical reports of the Ministry of Health and Welfare. The future demand for radiologists was based on Taiwanese people aged 40 and over. RESULTS: The workforce of Taiwan's radiologists has increased by 6 % annually over the past 20 years (from 450 to 993), performing 2125, 3202 and 3620 monthly examinations (mainly conventional radiography and CT) in medical centers, regional hospitals and district hospitals. Between 2000 and 2020, the use of CT and MRI increased by more than 3.5 times. Demand for interventional radiology also increased by 1.77 times, 2.25 times, and 5 times, respectively. To maintain this volume of services in 2040, at least 1168 radiologists are needed, about 1.18 times more in 2020. CONCLUSION: Taiwan has 2.4 to 2.9 times fewer radiologists than the United States and 3 times fewer than Europe, while the annual workload is approximately 2 to 3.4 times greater than that of the United States and 1.4 to 2.5 times greater than that of the United Kingdom. This report may serve as a reference for policy makers who address the challenges of the growing workload among radiologists in countries of similar situations.