During the past hundred years, the forms of disease prevalent in Taiwan underwent a great change. In the early period, death from contagious diseases such as gastroenteritis, perinatal death, and malaria were the major threats to Taiwanese. After 1970, these three causes of death were no longer in the list of the top 10 causes of death. In recent decades, chronic illnesses and cancer have taken the place of the leading causes of death, which is a very different situation from that of the past. Tracing back the history of health problems in Taiwan, we focus on the top 10 causes of death and on common but not fatal diseases in order to illustrate the changes in public health in Taiwan. Many significant figures in the field of medicine have been invited to explain the changes in the instance of diseases; however, it should be noted that though the scholars are professionals in their fields of study, their interpretations are only personal opinions rather than factual history. Nevertheless, these records are still valuable for they not only show the past changes, but also point out the prospect of healthcare in Taiwan.

In regard to the top 10 causes of death, the earliest statistics date from 1952. Gastroenteritis, pneumonia, tuberculosis, heart disease, and central nervous system vascular lesions were the top five causes of death, and perinatal death, malignant tumor and malaria were ranked the 6th, 8th and 10th, respectively. Cerebrovascular disease was the leading cause of death for a long period of time between 1966 to 1981, being replaced by malignant tumor in 1982, when it was ranked the 2nd, and it was then the 3rd in 2007. As for malignant tumor, it has been ranked the 1st since 1982, and the death rate from this cause has been increasing year by year. Death from accidental injury was ranked the 8th in 1961, and then the 3rd from 1966 until 2002, when it was ranked the 6th. Tuberculosis was the top 3rd cause of death in 1952 and dropped to the 6th in 1961, after which it was for long ranked in the same place, and after its rank fell year by year, and it was no longer in the top 10 list in 1985. In the early period, heart disease was ranked from the 4th to the 6th place, due to the prevalence of contagious disease and the associated high death rates, until 1998, when it was ranked the 3rd, and later 2nd in 2007. Cerebrovascular disease has been in the top 3 from 2007 until now. Cirrhosis was not in the top 10 in the early years, but during 1971 to 2008, it was ranked from the 6th to the 8th. Suicide and self-mutilation were not in the top 10 causes of death originally, but from 1975, they have been in the list of the top 10 causes till present. Diabetes first appeared in the top 10 in 1983 as the 8th, till 2009, when it became the 5th. Kidney disease was ranked the 7th in 1952, and its position fell gradually, and it was sometimes out of the list, but it was in the 10th place as of 2008. Hypertension entered the top 10 list in 1971, and it went up and down in rank over the years, and then fell out of the list in 2008. As for malignant tumor, starting from 8th place in 1952, its rank became higher and higher year by year, and it has been was in the first place since 1982. Due to the fact that malignant tumor has long been the leading cause of death, it is necessary to analyze it in detail. The leading cause of death from cancer for males has been liver cancer since 1986, followed by lung cancer, gastric cancer, colorectal cancer, esophageal cancer, oral cancer, non-Hodgkin lymphoma and liver cancer. While this ranking has changed little afterwards, it is notable that the rank for oral cancer has risen over the years and it was ranked the 4th in 2003. Prostate cancer entered the ranking in 1994 and was ranked the 7th as of 2001. The latest statistics indicate that lung cancer has replaced liver cancer as the leading cause of death from cancer in males and that the rank of oral cancer is still on the rise.

In regard to females, lung cancer has been the main cause of death since 1986. On the other hand, cervical cancer was the 2nd, from 2006 to 2009, when it dropped to the 6th. Liver cancer was ranked the 3rd in the early years, but has been the 2nd from 1992 till now. Gastric cancer was the 5th in 2009, and colorectal cancer was ranked 5th in 1986 and then 3rd in 2009. It is significant that the rank for breast cancer rose from 6th to 4th place between 1986 and 1996. Breast cancer was still ranked high in the 4th place in 2009 and breast cancer patients in Taiwan are ten years younger than those in other countries. The importance of diseases does not lie merely in whether they are fatal or not. Diseases that are not fatal, but prevalent can still have a huge impact on people’s lives or even on the viability of a country. Thus, the discussion here also includes myopia, infertility, obesity and asthma. Although contagious diseases are not emphasized, rabies was eliminated in Taiwan as of 1959, and the elimination of malaria was announced by the W.H.O. in 1965, and, along with the disappearance of polio, these are all praise-worthy achievements. The changes in health problems indicate differences in environments; bad habits; and the intervention of the government and the public in support of healthcare. As convener at this time, I have written this article as a foreword; as for the detailed introductions to the important diseases, please read the sub-articles to find out more.