臨牀消化器内科 Vol.32 No.12(6)


特集名 内視鏡検診の実態と今後の課題
題名 胃内視鏡検診の精度管理体制構築と課題
発刊年月 2017年 11月
著者 加藤 勝章 宮城県対がん協会がん検診センター
【 要旨 】 胃内視鏡検診の死亡率減少効果が証明されたことを受け,2016年より胃X線検診に加えて胃内視鏡検診も対策型検診として実施可能になった.胃内視鏡検診は個別検診が主体となり,クリニックなどでの日常診療の延長として実施されることが多く,精度管理水準が低くなるおそれがある.日本消化器がん検診学会による「対策型検診のための胃内視鏡検診マニュアル」では,胃内視鏡検診を導入しようとする地域では,検診の運営を統括する組織(委員会)を設置することとされている.この委員会は,検診画像のダブルチェック,偶発症対策,検診データ管理などの精度管理を行う.加えて,プロセス指標を用いて検診が正しく行われているかのモニタリングも必要である.検診の質を維持するには正しい精度管理体制の構築が肝要である.
Theme Current Status and Future Perspectives of Endoscopic Screening
Title Establishment of an Accuracy Control Regimen for Population—based Endoscopic Screening of Gastric Cancer and Its Challenges
Author Katsuaki Kato Cancer Detection Center, Miyagi Cancer Society
[ Summary ] Following the scientific certification of a decrease in death rate from gastric cancer due to endoscopic screening, this procedure, in addition to the barium examination, has been implemented since 2016. Endoscopic screening for gastric cancer is predominantly carried out as an extension of daily medical care at medical clinics. This issue may frequently contribute to lowering the accuracy control level of the individual screening program. In the manual of the population‒based endoscopic screening for gastric cancer published by the Japanese Society of Gastrointestinal Cancer Screening, the inhabitants of the region where endoscopic screening for gastric cancer is going to be conducted as a population‒based program are required to establish a regional committee that administrates the implementation of the endoscopic screening. The committee should achieve accuracy control, including double‒checking endoscopic images, enforcing countermeasures against accidental occurrence, and data management. In addition, the monitoring of the accuracy of screening program using process indices is also necessary. The construction of a strict accuracy control regimen is essential to maintaining high quality of endoscopic screening for gastric cancer.
戻る