Early Lung Cancer Has High Recurrence Risk; Medical Community Urges Inclusion of Post-Surgery Targeted Therapy in National Health Insurance

(CNA, reporter Chen Jie-ling, Taipei, July 1) Early-stage lung cancer is prone to recurrence even after surgery. Over half of lung adenocarcinoma patients in Taiwan have gene mutations associated with a higher risk of recurrence and metastasis. Medical groups pointed out today that post-operative targeted adjuvant therapy can reduce recurrence risk by 80%, urging its prompt inclusion in National Health Insurance coverage.

Chang Chia-lun, Vice Executive Director of the Taiwan Cancer Foundation and Director of the Department of Hematology-Oncology at Taipei City Wanfang Hospital, stated at a press conference today that cancer has been the leading cause of death for the nation for 44 consecutive years, and lung cancer has been the top killer for 22 consecutive years. One out of every five cancer deaths in the country is attributed to lung cancer. With its high incidence rate, lung cancer has always been a top priority in Taiwan's cancer prevention and control efforts.

The Ministry of Health and Welfare's Health Promotion Administration has been providing free low-dose computed tomography (LDCT) screening for high-risk groups for lung cancer since July 1, 111 (2022). Chang Chia-lun said that in the four years since its implementation, 3,139 confirmed lung cancer cases have been identified, with over 80% being early-stage. The budgets for early cancer screening and the NT$10 billion cancer new drug fund are gradually in place. The next step should be to improve patients' accessibility to medications aligned with international guidelines.

Post-operative targeted adjuvant therapy for early-stage lung cancer (Stage 1B to 3A) to reduce recurrence has become an international standard guideline. Wang Chin-chou, Vice Superintendent of Kaohsiung Chang Gung Memorial Hospital, said that early-stage lung cancer accounts for 65% of cases in Taiwan. The increase in early-stage lung cancer detection has driven a rise in demand for early treatment. The more troublesome aspect of early-stage lung cancer is that it can recur even after surgical resection. Factors such as poor differentiation and lymphovascular invasion are types prone to recurrence.

Wang Chin-chou stated that over half of lung adenocarcinoma patients in Taiwan have EGFR gene mutations, which are associated with a higher risk of recurrence and metastasis. Their risk of recurrence and metastasis is about 1.3 times that of patients without gene mutations. For EGFR gene-mutated patients, the 5-year recurrence rate after surgery reaches 45% for Stage 1B, increases to 62% for Stage 2, and is 76% for Stage 3. For this group of patients, receiving post-operative targeted adjuvant therapy can reduce the recurrence risk by up to nearly 80%.

Wang Chin-chou emphasized that post-operative targeted adjuvant therapy for early-stage lung cancer patients is an international standard guideline and a consensus within Taiwan's medical community. It is expected to reduce the lung cancer mortality rate by 10% in five years. He urged alignment with international guidelines and accelerated inclusion of post-operative targeted adjuvant therapy in insurance coverage. It is crucial to seize the golden period for post-operative targeted adjuvant therapy to improve patient survival and promote the sustainable development of National Health Insurance and social medical resources.

Ms. Lin, 52, shared her experience. Years ago, her company subsidized employees for LDCT examinations, during which a nodule was found in her lung. Due to a busy work schedule and no discomfort, she did not pay much attention and did not follow up. It wasn't until she heard a radio program sharing similar experiences that she decided to make an appointment for further examination. After surgery and pathological examination, she was diagnosed with Stage 1B lung cancer.

"I always thought lung cancer was very far from me," said Ms. Lin, who does not smoke, has no family history of cancer, and does not cook. She never imagined she would develop lung cancer. She is fortunate to have detected it early through low-dose CT scans and even more fortunate to have commercial insurance, which covered the targeted adjuvant therapy costing over NT$3 million for three years post-surgery. She cannot imagine how she would have managed without insurance. (Editor: Chen Ching-fang) 1150701

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