Promoting Cancer Screening in

Routine Health Services

Tumor Center, Changhua Christian Hospital

Dr. Chang Tung-Hao

Program

Introduction

Integration / Promotion in CCH

Adding value and saving lives

Conclusion

Introduction

From Taiwan government’s regulation and the support of

Health and Welfare Surcharge, Health Promotion

Administrtion designed ”cancer quality improvement

project”.

Introduction

Cancer screening program

After the explanation session of this project in late 2009,

we prompted our action within 3 months.

Introduction

2012

2013

Introduction

Our service area covers a population of more than 1.3 million.

We have more than 60 subspecialties

OPD：5,000 visits/day

Total beds：1,676 beds

Program

Introduction

Integration / Promotion in CCH

Adding value and saving lives

Conclusion

Integration / Promotion in CCH

In this large-scale hospital, our cancer prevention and

control programs are under the same leadership.

Superintendent

Dr. Kuo

Cancer committee

Chairman, vice superintendent

Dr. Soon Chemotherapy audit team

Tumor centerExecutive unit

Cancer registry audit team

Multidisciplinary teams

Cancer screening committee

Chairman, vice superintendent

Dr. Soon

Integration / Promotion in CCH

Integration / Promotion in CCH

11

Case managers for cancer

screening

Integration / Promotion in CCH

Integration / Promotion in CCH

After brain storming and process design for cancer screening,

we extensively use information systems in our daily works.

Integration / Promotion in CCH

SOP

Integration / Promotion in CCHInformation systems

1. screening referral system

Integration / Promotion in CCHInformation systems

2. screening integration system

Integration / Promotion in CCHInformation systems

3. follow-up system for positive cases

Integration / Promotion in CCHInformation systems

4. systems for cancer screening case managers

Cervix smear (Clinic 140)

Oral cancer screening (Clinic 119)

Screening mammography (Clinic 170)

Colorectal cancer screening (Clinic 42)

Integration / Promotion in CCH

Integration / Promotion in CCH

Personal Incentive

Team Incentive

Promotion in different media

20/

72

Electronic bulletin board OPD list Publication

News letters Web page Notes

Integration / Promotion in CCH

Promotion in our lobby

Integration / Promotion in CCH

Deliver cancer screening services in rural areas

Integration / Promotion in CCH

Program

Introduction

Integration / Promotion in CCH

Adding value and saving lives

Conclusion

Adding value and saving lives

Once our patients fit the screening criteria, we invite

them to have these adding value services.

Cervical cancer screening

Colorectal cancer screening Oral cancer screening

Breast cancer screening

Completion rates in 2013

Adding value and saving lives

Adding value and saving lives

We also established the colorectal cancer screening

criteria for Taiwan (this is supported by the project from

Health Promotion Administrtion) and we always teach

case managers of different hospitals.

workshopsymposium

Adding value and saving lives

Our people did get adding value when they visited

their near-by hospitals and we did save more lives

after cancer screening program.

year

Coverage rate(%)

2004 2005 2006 2007 2008 2009 2010 2011 2012

The screening rate for colorectal

cancer was around 10% before

the support of Health and Welfare

Surcharge.

Adding value and saving lives

Screening number Positive cases Cancer cases

year 2010 2011 2012 2010 2011 2012 2010 2011 2012

Cervical cancer

screening18899 5741 5476 418 129 136 11 47 50

Screening

mammography11272 10841 11639 873 949 1070 94 79 102

Oral cancer

screening7502 3387 4923 2447 922 1566 156 90 129

Colorectal

cancer

screening

12490 7208 11522 1075 614 924 22 18 32

total 50163 27177 33560 4813 2614 3696 283 234 313

colorectal cancer screening

Cases

screene

d

Positive

cases

Call-back

completedpercentage

全部(222 hospitals) 451,998 32,585 18,036 55.4%

國立臺灣大學醫學院附設醫院(NTUH)8,456 562 349 62.1%

行政院國軍退除役官兵輔導委員會臺北榮民總醫院(VGH)7,580 678 192 28.3%

新光醫療財團法人新光吳火獅紀念醫院(SKH)7,612 768 469 61.1%

中國醫藥大學附設醫院(CMUH)7,878 751 366 48.7%

奇美醫療財團法人奇美醫院(Chi-Mei Hospital)8,676 955 636 66.6%

長庚醫療財團法人高雄長庚紀念醫院(CGMH-Kaohsiung)14,498 1,146 752 65.6%

長庚醫療財團法人基隆長庚紀念醫院(CGMH-Keelung)8,804 654 368 56.3%

醫療財團法人徐元智先生醫藥基金會亞東紀念醫院(FEMH)7,900 412 289 70.1%

長庚醫療財團法人林口長庚紀念醫院(CGMH-Linko)10,347 777 438 56.4%

財團法人彰化基督教醫院(CCH) 9,321 771 556 72.1%

資料來源：國民健康局管考系統 (統計時間101.01.01-101.08.30，篩檢量7500案以上醫院)

Positive cases call-back in colorectal cancer

screening (2012-1~2012-8)

Adding value and saving lives

No. 1

Program

Introduction

Integration / Promotion in CCH

Adding value and saving lives

Conclusion

Conclusion

Conclusion

Eventually, we hope that we can get stage-shift in the

cancers we screened and save more lives just like what

we achieved in cervical cancer.

Thanks for your attention