Letter From the Taiwan Society of Pulmonary and Critical Care Medicine

The Taiwan Society of Pulmonary and Critical Care Medicine (TSPCCM) traces its origins to the early 1950s, a period in which Taiwan faced an overwhelming burden of tuberculosis (TB) and lacked formal structures for respiratory medicine. The TSPCCM developed from the Taipei Chest Case Joint Conference, which was an informal weekly gathering that began in 1951. The conference was attended by visionary pioneers and was the earliest platform in Taiwan for multidisciplinary exchange on chest medicine. The conference had an inclusive culture, uniting physicians trained under various systems, and laid the foundation for the development of a collaborative academic community in Taiwan. In 1959, this group was formally reorganised as one Chapter of the International Academy of Chest Physicians and Surgeons, with this serving as the predecessor of the TSPCCM. Over subsequent decades, the society broadened its scope to include pulmonary medicine, interventional pulmonology, infectious diseases, sleep medicine, lung cancer care, and critical care medicine, eventually evolving into the TSPCCM of the modern day. Today, the TSPCCM has more than 1900 members and is a key professional organisation advancing respiratory health in Taiwan, addressing major diseases such as chronic obstructive pulmonary disease (COPD), TB, and lung cancer. COPD is underdiagnosed in Taiwan, indicating a need to raise public and professional awareness of early evaluation and timely treatment for the disease in individuals with chronic airway symptoms. A recently validated two-stage, risk-stratified strategy combining the COPD Diagnostic Questionnaire with FEV1/FEV6 measurement was demonstrated to be an accurate and cost-effective means of identifying at-risk individuals with previously unrecognised COPD [1]. Beyond case finding, Taiwan's population-level COPD outcomes have also improved markedly. A nationwide join-point regression analysis of 100,147 COPD-related deaths over 2 decades revealed an annual average decline in age-standardised mortality of 3.79% between 2002 and 2022 [2]. The decline was most pronounced after 2016, corresponding with the strengthening of tobacco control policies, improvement in inhaler access and expansion of the integrated COPD care program in Taiwan. These improvements position Taiwan as significantly reducing COPD mortality and highlight the combined influence of preventive policy and structured chronic care models. Taiwan's Health Insurance Administration—recognising the substantial disease burden and comorbidity risks of COPD—has strengthened its pay-for-performance program for COPD to enhance care quality and encourage broader participation among healthcare providers. Taiwan's efforts to control and eliminate TB have yielded remarkable results. Between 2005 and 2023, the TB incidence rate declined by 62%, decreasing from 73 to 28 cases per 100,000 population, which is one of the most substantial reductions in the Asia-Pacific region during that period [3]. This progress is the result of the coordinated implementation of key strategies, beginning with the ‘Ten-Year Halving Tuberculosis Plan’ (2006–2015) and continuing through phases of the ‘End TB by 2035 Project’. Whereas early gains were largely driven by active case finding and the adoption of modern diagnostic tools, Taiwan's current efforts towards addressing TB are focused on proactive prevention through latent TB infection (LTBI) treatment programs and expanded LTBI screening among close case contacts and high-risk populations. Taiwan is pioneering efforts to redefine lung cancer risk stratification by identifying high-risk individuals who have never smoked—an epidemiologic pattern often underestimated by international screening guidelines. The Taiwan Lung Cancer Screening in Never-Smoker Trial (TALENT), a nationwide, multicenter prospective cohort study conducted at 17 tertiary medical centres, enrolled more than 12,000 participants and detected lung cancer in 2.6% of these individuals, with 2.1% having invasive disease [4]. The TALENT study demonstrated that among never-smokers, a family history of lung cancer in first-degree relatives was significantly associated with an increased risk of lung cancer, and the likelihood of invasive pathology rose with advancing age. These findings support low-dose CT screening programs currently covering both smokers and never-smokers. Future directions aim to integrate molecular profiling with imaging-based risk models to distinguish aggressive adenocarcinomas from indolent lesions such as adenocarcinoma in situ, reducing the number of unnecessary interventions in cases detected by screening. In addition to the aforementioned achievements, the TSPCCM has also participated in the development of major global disease registries, including the International Severe Asthma Registry, and has developed her own registries, such as the interstitial lung disease registry to generate real-world evidence and strengthen international connectivity. As an en-bloc member of the Asian Pacific Society of Respirology since 2006, TSPCCM continues to foster regional collaboration and has recently hosted major scientific events, including the 9th Asia Pacific Region Conference of the International Union Against Tuberculosis and Lung Disease (APRC 2024, Figure 1) and the Asian Pacific Congress on Bronchology and Interventional Pulmonology (APCB 2025). In the future, the TSPCCM will continue to support research that reflects the unique characteristics of Taiwan's population and will embrace new technologies that can improve patient care across the island. In the face of challenges posed by an ageing society and emerging respiratory diseases, the TSPCCM remains committed to collaborating closely with clinicians, policymakers, and patient communities to improve pulmonary health in Taiwan and to contribute meaningfully to the respiratory community in the Asia-Pacific region. The authors have nothing to report. The authors declare no conflicts of interest.