Cancer is becoming a more important health problem in Taiwan with aging of populations and changes in lifestyles. This indicates that a population-based cancer registration database is essential to providing informative data on cancer prevention and policy setting. The Taiwan Cancer Registry was launched in 1979 and all reporting hospitals were mandated to submit cancer data to the central cancer registry following the enactment of the Cancer Control Act in 2003. The National Health Insurance program in Taiwan has successfully provided quality health care, comprehensive benefits and convenient access to treatment. Most cancers had a rapidly increasing incidence after the initiation of the NHI program. However, cancer incidence rates of nasopharynx of both genders slightly decreased throughout the entire period and incidence of stomach cancer of both genders and cervical cancer of females declined beginning in 1995. For childhood cancers, the major types of leukemia, lymphomas, central nervous system neoplasms and other epithelial neoplasms for males and females accounted for nearly 55% of all types. This study presents for the first time the secular changes and age patterns in the incidence of childhood cancer using national cancer data.

The incidence of breast and genital tract cancers is increasing among Taiwanese women, but the age specificity and histopathological features of these cancers have not been determined. We used a descriptive epidemiological method and data from the Taiwan Cancer Registry (1979Registry ( -2007 to examine secular trends in the age-specific incidences of female breast cancer, three major female genital tract cancers and the histopathological subtypes of these cancers. Age-specific incidence rates in the United States (1978States ( -2002 were used as an external reference, and the incidence rates of all malignancies and of malignant brain tumors were used as internal references. We found that age-adjusted incidence rates of female breast, uterine, and ovarian cancers increased in Taiwan from 1979 to 2007, whereas the incidence of cervical cancer decreased after 1998. The largest increase was observed for ductal and lobular carcinomas of the breast and endometrioid carcinomas of the uterus and ovary in women 55 years, all of these tumors show a high prevalence of hormone receptor expressions. In addition, hormone-receptor-positive rates of breast cancer were uniquely higher in younger, as opposed to older, Taiwanese women. These findings indicate that estrogen-related cancers rapidly emerge in young women in Taiwan and that incidence rates are catching up with that of women living in the United States.The incidences of breast and gynecological cancers are thought to differ significantly between Asians and Caucasians. For example, the frequency of cervical cancer has been reported to be significantly higher among residents of Southeast Asian, when compared to non-Asian, countries. 1-3 In contrast, breast, uterine and ovarian cancer frequencies are reported to be significantly lower in most parts of Asia when compared to other regions. 4 In recent decades, however, the incidences of breast, uterine and ovarian cancer have been increasing in certain rapidly developing Asian countries such as Singapore, Korea, Japan and Taiwan. 5-10 Previous age-period-cohort analyses revealed a much stronger birth cohort effect on the incidence of breast cancer for Taiwanese and Japanese, when compared to Caucasian American, women. 7,8,11 This stronger birth cohort effect was found to correlate directly with a rapid increase in the incidence of early-onset breast cancer in Taiwan and Japan.Similar to that of breast cancer, the incidence of uterine cancer in Japan has increased in women less than 40 years of age. The incidence of ovarian cancer has also increased markedly in Japanese women over 60 years of age, whereas the incidence of cervical cancer has declined significantly among Japanese women aged 40-80 years. 9 Whether the agespecific incidence changes of these cancers exist in other Asian countries, however, remains to be determined.Taiwan has become increasingly industrialized since the 1960s. In our study, the cancer registration system in Taiwan, established in 1979, was utilized to ascertain whether the unique age-specific cha...