| Theme | Current Status and Future Perspectives of Endoscopic Screening | |
|---|---|---|
| Title | Current Status of Colorectal Cancer Screening Using the Fecal Immunochemical Test in Japan | |
| Publish Date | 2017/11 | |
| Author | Ryoichi Nozaki | Division of Gastroenterology, Coloproctology Center, Takano Hospital |
| Author | Takayuki Hara | General Screening Center, Coloproctology Center, Takano Hospital |
| Author | Yasuki Shiiba | General Screening Center, Coloproctology Center, Takano Hospital |
| Author | Hironori Kuroda | General Screening Center, Coloproctology Center, Takano Hospital |
| Author | Kazutaka Yamada | Division of Gastroenterological Surgery, Coloproctology Center, Takano Hospital |
| [ Summary ] | In Japan, colorectal cancer (CRC) ranked first among all cancers in terms of incidence since 2015 and ranked second for mortality ; the rates are predicted to continue to increase. As a countermeasure against this, the Japanese government is aiming to achieve a CRC screening rate of 50 % (a near‒term target of 40 %). The efficacy of CRC screening by fecal occult blood testing has already been proven. The method used in Japan is the two‒day fecal immunochemical test (FIT). The rate of CRC screening by the two‒day FIT is 35.4 %, which is below the target rate. The rates remain very low when compared with the high rates achieved in the United States (US) and United Kingdom (UK) (72 % and 50‒60 %, respectively). There are disparities in the screening rates among prefectures and regions. For example the Tohoku region generally has higher screening rates than other regions. The percentage of close examinations for a positive two‒day FIT is 66.0 %, which falls below the acceptable level in Japan. As previously mentioned, the current CRC screening rate and the close examination rate are not as good as those in Western countries where declines in CRC mortality have been observed as a result of screening. A joint project by our hospital. Takano Hospital and K city (in Kumamoto prefecture) aiming to improve the CRC screening rate (a 3‒year plan) has achieved an increase in the rate improving from 23.2 % to 44.4 % in the second year. As a model case, the project is still ongoing with the aim of achieving a rate of 50 % in the third year. | |