口腔癌流行病學

1. 口腔癌流行病學 吳建遠 國民健康局癌症防治組 97年6月

2. 檳榔造成之醫藥衛生問題 • 「同時有吸菸與嚼檳榔習慣」是人類第一類致癌物，造成口腔、咽、喉及食道等部位癌症（1992，IARC ） • 「單純檳榔子」是人類第一類致癌物（2003，IARC ） • 造成口腔病變，如口腔黏膜纖維化、白斑症等 • 可能與糖尿病、懷孕併發症及肝癌等疾病有關

3. Age-Adjusted Incidence Rates of Oral Cancer in Asian-Oceania Selected Regions Age-adjusted Incidence Rates (per 100,000) *Adapted from Cancer Incidence in Five Continents, Volume VIII, 2002. *Lip, Oral Cavity, Oropharynx and Hypopharynx are included.

4. Age-adjusted incidence and mortality for the past 10 years Male incidence Male mortality Female incidence Female mortality Rate (/105) Year Definition of Oral Cancer :ICD-9-CM (140-149, exclude 142 and 147)

5. Male Incidence and Mortality of the leading Five cancers in Taiwan (unit: per 105 men)

6. Stage at diagnosis Source: Taiwan Cancer Data Bank,2004

9. Topography

10. Histopathology N.B. Above 95% cases were microscopically varified.

11. Medical Expenditure, 2003 Source： http://www.doh.gov.tw/statistic/medical annual report/92.htm

12. Prevalence of Chewing Betel Quid Among Taiwanese Adults Source: 1、Lee-Lan Yen,1996,   Study on Taiwanese Adolescents and Adults’ Knowledge and Behavior of Betel Nut Chewing. 2、Lee-Lan Yen,1999 ; Study of The Behavior of Chewing Betel Quid Among Taiwanese Adults. 3、Tien-yu shieh,2001 Prevalence of Areca/Betel Quids Chewing and Smoking, and a Study of Cognition of Health Hazards Caused by Chewing Areca/Betel Quids.  4、KAP Study on Health Promotion ,BHP,2002

13. Consumption v.s. mortality per capita betel quid consumption Per capita consumption Age-standardized mortality rate standardized oral cancer mortality Source: Statistical Year Book (2003) & Department of Health (2003)

14. 口腔癌防治策略 一、辦理宣導教育 大眾傳媒：建立不嚼檳榔社會常模 小眾宣導：於特定場域建立不嚼檳榔支持環境（如：學校、軍隊、社區、職場、公務體系等） 二、落實現有法令（兒少法） 三、協助民眾戒嚼檳榔 四、減少檳榔供應、協助檳榔農轉作 五、以價制量，評估徵檳榔健康捐可行性 六、辦理口腔癌篩檢，早期發現早期治療

15. Result of Screening（2004-2005）

16. Thank you for your attention.