臨牀消化器内科 Vol.23 No.3(3)


特集名 胃癌スクリーニングの現況とハイリスクストラテジー
題名 X線による胃癌スクリーニングの現状と問題点
発刊年月 2008年 03月
著者 今村 清子 横浜市立市民病院がん検診センター
【 要旨 】 2007年4月に施行されたがん対策基本法では,国民には責務として検診受診を勧め,検診機関には検診方法,事業評価,医療従事者の研修の機会の確保,受診率向上策の検討などの必要性を求めている.胃がん検診においては,長い歴史のなかでX線によるスクリーニングを行ってきたが,厚生労働省から,胃癌死亡率減少効果を示すエビデンスが示され対策型検診としての評価を受けている.現在,新・撮影法による撮影技術と読影力向上を目標に新たな認定方法が検討されているが,これにより精度管理が強化され,研修医や撮影技師の教育,保健師活動の活性化,検診機関の格差是正が期待できる.
Theme Gastric Cancer Screening -- Present Status and Uprising High-risk Strategy
Title X-ray Examination and Screening for Gastric Cancer -- Current Conditions and Associated Problems
Author Kiyoko Imamura Division of Cancer Detection Center, Yokohama Municipal Citizen's Hospital
[ Summary ] In the fundamental regulations concerning cancer care measures enacted in April 2007, medical examinations and consultations are considered obligatory. Medical examination methods, project evaluation and outlines for training medical staffs are provided for organization performing examination. The necessity for improvements in examination and consultation rates has been demonstrated. Evidence indicating the effects of these measure is demonstrated by the decrease in stomach cancer mortality rates, as shown by Ministry of Health, Labour and Welfare statistics. The evaluation of population-based screening has been achieved over an extended period, through X ray examinations for stomach cancer. Increases in accuracy have been achieved and doctors in training and radiologists should be educated accordingly. The activities of public health nurses and the examining medical organizations can be expected to correct problems though new scanning techniques which will help to improve accuracy. Further education of doctors, radiologists, and also the expansion of the activities by public health nurses, will help eliminate deficiencies in screening for gastric cancer.
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