Oral cancer is a major public health problem in Taiwan. It is largely attributable to the widespread areca nut and betel quid chewing habit. Based on national health surveys, the betel quid chewing rates in Taiwan have declined since 2007. After significant
increases in past several decades the age-standardized incidence rate of oral cancer has plateaued since 2009. We published a commentary in the journal of Oral Oncology (July 28, 2020) to report on the incidence and current trends of oral cancer in Taiwan and to describe some of the important government policy and strategies introduced in order to control betel quid use aimed at preventing oral cancer among the Taiwanese population.
Taiwan declared December 3rd as “Areca Prevention Day” In 1997 to raise public awareness on areca/betel quid hazards. Government agencies together with NGO resources collaborated to create areca/ betel quid-free supporting environments in communities, school campuses, military bases, and workplaces with high prevalence of betel quid chewing. The main tasks were to promote oral cancer awareness through the health care system, mass media and school-based programs to halt an increase in new users, and to monitor prevalence of areca nut chewing in adults and adolescents. Simultaneously, the government Health Promotion Administration (HPA) supported areca/betel quid cessation programs by designing culturally sensitive cessation teaching materials as well as identifying feasible strategies to implement betel quid cessation programs in high-risk communities and workplaces.
Taiwan is the only country in the world do initiate a sustained national oral cancer screening program. HPA targeted betel quid chewers (including exchewers) and cigarette smokers aged above 30 years old for biennial oral mucosal screening.
To decrease the supply of betel quid, the Council of Agriculture worked to substitute areca trees by other cash crops. The Environmental Protection Administration enforces the Waste Disposal Act by prohibiting individuals from spitting betel quid juice, and any violators are fined and ordered to attend a four-hour betel cessation class. To encourage active participation by employers in industries with high betel quid chewing rates, the Occupational Safety and Health Administration of the Ministry of Labor delivered Golden Safety awards to industries in recognizing their compliance with betel quid control policies. In summary, the national areca nut and betel quid cessation program has demonstrated a significant positive impact on oral cancer prevention in Taiwan.
For the full text of the publication, visit https://www.ncbi.nlm.nih.gov/pubmed/32712006