Why Not Follow Guidelines? Challenge of HPV Testing to Cervical Cancer Screening Program in Taiwan

• In Event: Emergent Technologies in Biomedicine and Healthcare: Boundaries, Tensions, and Possibilities - III

Abstract

In decades after introduced, cervical pap smears tremendously decrease the prevalence of cervical cancer and relating death among women. The government-funded pap smear program was launched for women aged 30 and more in Taiwan since 1995 and successfully has the disease away from the top ten women cancers. However, even widely proved as an effective screening tool, this old technique faces the challenge from human papillomavirus (HPV) testing, which is regarded as an alternative screening method. The association between cervical cancer and high-risk HPV was established in the late 90s. The relating molecular technique detecting HPV was incorporated in the cervical screening guidelines announced by several academies in the U.S in the recent decade. However, the public health system in Taiwan failed to respond to such revision of guidelines.
With participant observation and literature review, I try to demonstrate the complex network connecting this emerging technology and the old professionals in cervical screening policy in the socioeconomic context of Taiwan. The low priced and easily accessible pap smears and the existing system for the screening professionals cause no benefits for the incorporation, and instead, preventing the inclusion of HPV testing from the public health program. The efficacy and effectiveness of the emerging technology in the public health system is thusly scientifically and socially co-produced. lacking the public reimbursement, the rise of the self-pay market also enhances the commodification of the risk of sexually transmitted HPV.

Author

• Yeh-Han Wang, Division of Policy and Law, Institute of Public Health, National Yang-Ming University, Taipei Taiwan