Taiwan's gastric cancer screening guidelines published in top journals, hailed as cost-effective 'Taiwan model' for global adoption

Taiwan's National Taiwan University Hospital has achieved a significant milestone in gastric cancer prevention, with its guidelines for screening now published in two prestigious international journals: The Journal of the American Medical Association (JAMA) and The New England Journal of Medicine (NEJM).

The "Taiwan model" for gastric cancer prevention, which emphasizes testing for Helicobacter pylori (H. pylori) infection, has garnered international attention, with several countries expressing interest in adopting the approach. Gastric cancer ranks as the eighth leading cause of cancer death in Taiwan. The nation initiated a public gastric cancer screening program this year, aiming to identify at-risk individuals early.

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H. pylori infection increases the risk of gastric cancer by six times compared to the general population. Although we cannot completely cure gastric cancer, current technology can completely cure the bacteria.

Dr. Li Yi-chia, a physician from NTU Hospital's Department of Internal Medicine, explained that individuals infected with H. pylori face a six-fold higher risk of developing gastric cancer. While a complete cure for gastric cancer remains elusive, current technologies can effectively treat the bacterial infection. NTU Hospital has been researching the simultaneous screening for colorectal cancer fecal occult blood and H. pylori fecal antigen for a decade, confirming its dual protective effect and potential to reduce gastric cancer mortality by 14%.

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The current gastric cancer screening policy initially started as a pilot program in indigenous areas, with the team led by Dr. Li Yi-chia conducting H. pylori testing. It was gradually expanded to general areas in 2024 and officially became the '6th cancer' in the national cancer screening program last year. As of July this year, 600,000 people have undergone screening, with a positive rate of 22.4%.

Furthermore, the H. pylori fecal antigen test is projected to save national healthcare expenditures by reducing future treatment costs and losses in quality of life. A cost-benefit analysis for Taiwan indicates that the program is cost-effective when the H. pylori infection rate exceeds 32.8%. For countries with higher medical costs, like the United States, the threshold is below 22%. This suggests that nations with similar or higher gastric cancer incidence rates, including immigrant and vulnerable populations, could achieve comparable benefits if they already have a colorectal cancer screening platform in place. These findings were published in JAMA in July 2026.

Taiwan's extensive experience in gastric cancer screening also led to the team's participation in a working group by the International Agency for Research on Cancer (IARC). Collaborating with 35 experts from 20 countries, they developed global guidelines published in NEJM in March 2026. Following the presentation of Taiwan's screening experience, countries in South America, Eastern Europe, and Bhutan have expressed their willingness to adopt Taiwan's prevention methods.

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The current gastric cancer screening policy initially started as a pilot program in indigenous areas, with the team led by Dr. Li Yi-chia conducting H. pylori testing. It was gradually expanded to general areas in 2024 and officially became the '6th cancer' in the national cancer screening program last year. As of July this year, 600,000 people have undergone screening, with a positive rate of 22.4%.