MOHW denies free LDCT screening leads to lung cancer overdiagnosis

Taipei, March 18 (CNA) Taiwan's Ministry of Health and Welfare sought to allay concerns on Wednesday that the country's free lung cancer screening program has led to overdiagnosis, noting lobectomy numbers have not risen significantly.

Since 2022, the ministry's Health Promotion Administration (HPA) has offered free low-dose computed tomography (LDCT) screening for heavy smokers and nationals with a family history of lung cancer, making Taiwan the first country in the world to do so.

However, in an op-ed published by a local media outlet on Saturday, Wayne Gao (高志文), a professor at Taipei Medical University's College of Public Health, asserted that the widespread use of free LDCT screening has led to lung cancer overdiagnosis in Taiwan.

Furthermore, Gao argued that the use of LDCT screenings over the last 10 years has subjected many patients to "unnecessary" lobectomies.

Chen Lian-yu (陳亮妤), head of the National Health Insurance Administration (NHIA), replied to media inquiries that NHIA data shows the number of patients undergoing lung-related resection surgery rose 2 percent from 21,309 in 2023 to 21,753 in 2025.

Types of lung resection surgeries include lobectomy, segmentectomy and wedge resection.

From 2023 to 2025, the annual number of patients undergoing lobectomies increased from 4,161 to 4,311, according to NHIA data.

Meanwhile, segmentectomy cases rose by 553 and wedge resections fell by 259, according to NHIA estimates.

LDCT screening has been promoted for three years, but the number of surgery cases has not shown a significant fluctuation, Chen said.

The number of lobectomy cases, which has drawn the most public attention because it involves the removal of a lung lobe, stands at about 4,000 annually and is "quite stable," she added.

Addressing concerns about overdiagnosis and unnecessary surgery, Chen said that in 2025, more than 92 percent of the 21,753 patients who underwent lung-related resection surgery held Major Illness/Injury Certificates for lung cancer, a relatively high ratio.

For hospitals seeing a higher volume of surgeries where the final diagnosis turns out not to be lung cancer, Chen added that the NHIA has stepped in to help review and guide their surgical practices.

In the future, the NHIA will compare data with the HPA to better track the subsequent treatment of patients who test positive in LDCT screening, Chen said.