| 特集名 | 大腸癌 -- 最新の進行大腸癌治療戦略 | |
|---|---|---|
| 題名 | 早期診断または早期発見 (1) 大腸がん検診の意義 | |
| 発刊年月 | 2000年 11月 | |
| 著者 | 小林 世美 | 愛知三の丸病院内科 |
| 著者 | 加藤 忠 | 愛知診断技術新興財団医療医科学研究所 |
| 著者 | 春日井 達造 | 名古屋記念病院 |
| 【 要旨 】 | 便潜血検査を用いる大腸がん検診は簡便かつ安価で，欧米および本邦における研究で大腸がん死亡率の減少が証明された．そこで厚生省は1992年，大腸がんの死亡率減少と医療費節減を目的に便潜血検査による大腸がん検診を老人保健事業に組み入れた．1998年に一般財源化されたが，受診者は500万人を突破した．1998年3月に出された「がん検診の有効性に関する報告書」では，「便潜血検査による大腸がん検診を勧奨する十分な証拠がある」と位置づけられた．診療の現場でも大腸がんの発見に対する便潜血検査の貢献度は増大している．発見がん中の予後の良いDukes A+Bがんの割合が高く，近い将来，全国的に大腸がん死亡率減少が期待される． | |
| Theme | Up-to-date Therapuetic Strategy for Advanced Colorectal Cancer | |
|---|---|---|
| Title | The Significance of Colorectal Cancer Screening | |
| Author | Seibi Kobayashi | Department of Internal Medicine, Aichi Sannomaru Hospital |
| Author | Tadashi Kato | Aichi Medical Foundation of Diagnostic Technology |
| Author | Tatsuzo Kasugai | Nagoya Memorial Hospital |
| [ Summary ] | Fecal occult blood testing is a simple and inexpensive method of screening for colorectal cancer. Reducing mortality from colorectal cancer by screening for fecal occult blood has been reported by some radomized controlled trials and case-control studies. In 1992, the Japanese government started colorectal cancer screening by fecal occult blood testing with immunochemical tests, as a national project. The number of participants exceeded 5 million in 1998. Through the period from 1992 to 1998 ,the rates of positive occult blood tests and persons having detailed examinations from those with positive tests were nearly 7.0% and 60.0%, respectively. Colorectal cancers were found in approximately 0.15% and the positive predictive value was 2.0 to 2.2%. There has been criticism of compliancerates of detailed examinations, which were considerably low through this period. This should be improved by continuing efforts in health education for the participants. In both mass screening and clinical practice, localized tumors of Duke's A and B were found in 70 to 80% of the patients with colorectal cancer, in the screened population. To reduce the mortarity nationwide, the number of participants should be increased up to 30% of the general population. |
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