1. Early Detection of Cancers and Chronic
Diseases
Sam Li-Sheng Chen
School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taiwan
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On behalf of Taiwan Cancer Screening Evaluation Group
4. 4
For KCIS no. 1
The public’s positive orientation
toward Prevention and early
detection, combined with
dependable health education
from their physician and other
trusted sources, can lead to an
informed consumer who will
readily accept an effective,
evidence-based model for
periodic preventive health
encounters.
KCIS study challenge us to move
beyond opportunistic preventive
care.
5. Chronic diseases & Cancers
Mets associated with Colorectal Adenoma: OR=1.43(1.01-2.02)
Mets associated with Oral Neoplasm: OR=1.68(1.03-2.75)
Hyperglycemia associated with HCC: OR=1.6(1.16-2.21)
Hypertension associated with Colorectal Neoplasm: OR=1.42(1.06-1.89)
Hypertension associated with Oral Neoplasm: OR=1.67(1.07-2.59)
Obesity associated with Oral Neoplasm: OR=1.89(1.23-2.90)
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Cancer 2004;100:1734–43
10. Materials & Methods
Study design
Before-and-after quasi-experiment design by
comparing the mortality before (1987 to 1999 ) and
after (2000 to 2012) community-based integrated
screening (CIS) with identical 13 year epoch
Age standardized observed mortality in post-screening
phase was used to compare with the age standardized
expected mortality for compared groups in pre-
screening phase
Considering the selection-bias adjustment
11. Coverage Rate in KCIS program
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0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
30-39 40-49 50-59 60-69 70-79
CoverageRate
Male Female
80%
54%
12. Relative Standardized Mortality Rate for
attendant and non-attendant
Gender Attendant Non-Attendant Overall KCIS
RR(95%CI) RR(95%CI) RR (95%CI)
Male 0.51(0.48-0.55) 1.00(0.99-1.02) 0.83(0.81-0.85)
Female 0.55(0.51-0.59) 0.88(0.85-0.90) 0.73(0.71-0.75)
Total 0.50(0.47-0.53) 0.95(0.93-0.96) 0.77(0.76-0.79)
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13. RR in comparison between nationwide and
Keelung city
Age
Keelung Nationwide
RR
(95% CI)
RR
(95%CI)
RR
(95% CI)
RR
(95%CI)
30-39
0.94
(0.88-0.99)
0.839
(0.835-0.844)
40-49
0.93
(0.89-0.96)
0.919
(0.915-0.923)
50-59
0.78
(0.75-0.81)
0.757
(0.754-0.760)
60-69
0.71
(0.68-0.73)
0.737
(0.735-0.739)
70-79
0.76
(0.74-0.78)
0.772
(0.771-0.774)
Total
0.77
(0.76-0.79)
0.77
(0.76-0.79)
0.851
(0.850-0.852)
0.851
(0.850-0.852)
14. Specific Causes
Mortality Reduction
Male Female
Heart Disease 0.82(0.77-0.88) 0.57 (0.48-0.65)
Cerebrovascular Disease 0.57 (0.51-0.63) 0.41 (0.33-0.49)
Diabetes Mellitus 0.98 (0.91-1.06) 0.72(0.65-0.79)
Hypertension 0.43(0.27-0.59) 0.35 (0.16-0.54)
Chronic Liver Disease or Cirrhosis 0.69 (0.62-0.77) 0.77 (0.64-0.89)
Colorectal Cancer* 0.92(0.76-1.07) 1.11(0.95-1.26)
Liver Cancer 0.82(0.76-0.88) 0.90(0.80-1.00)
Cervical Cancer - 0.54(0.38-0.71)
Breast Cancer - 1.37 (1.24-1.51)
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* 50-69 yrs
15. Conclusions
• CIS has served over 120,000 Keelung people and saved
numerous lives over the past decade.
• The 26% significant mortality reduction after 13-years of
follow-up in the CIS programme has been demonstrated.
• CIS prevents deaths from hypertension by 57%-65%, followed
by 43%-59% in cerebrovascular disease, and 23%-31% in
chronic liver diseases.
• CIS also prevents deaths from cancer by 14%, a remarkable
46% decrease death rate in cervical cancer
• This suggests a multiple screening programme considering
multiple disease prevention is effective in prolonging the life.
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16. Acknowledgements
• Health Promotion Administration, Ministry of Health and
Welfare
• Public Health Staff in Community
• Medical Professionals in Hospitals
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