| 特集名 | CT colonography 2019―今日までの進歩と現状，そして大腸がん検診への展開 | |
|---|---|---|
| 題名 | CT colonographyの有用性を巡って (3) 検診受診率向上の観点から | |
| 発刊年月 | 2019年 03月 | |
| 著者 | 野崎 良一 | 大腸肛門病センター高野病院消化器内科 |
| 著者 | 有馬 浩美 | 大腸肛門病センター高野病院放射線科 |
| 著者 | 松本 徹也 | 大腸肛門病センター高野病院放射線科 |
| 著者 | 前崎 孝之 | 大腸肛門病センター高野病院放射線科 |
| 著者 | 伊牟田 秀隆 | 大腸肛門病センター高野病院放射線科 |
| 著者 | 山田 一隆 | 大腸肛門病センター高野病院消化器外科 |
| 【 要旨 】 | わが国は，大腸がん検診の検診受診率50％を，精検受診率は許容値70％以上（目標値90％以上）を達成することを目標としているが，未だ達成には至っていない． 最近，精密検査の手法として，全大腸内視鏡検査（TCS）で行うことが困難な場合は，CT colonography（CTC）あるいは，S状結腸内視鏡検査と注腸X線検査の併用法のいずれかを実施することが提言された．精検法としてCTCの本格的導入の機運が年々高くなってきている．CTCには精検受診率を向上させるキャパシティが十分にあり，診断精度はTCSと比べて遜色がなく，苦痛が少なく，安全性が高く，受診者の受容性も良好であることから受診率向上への寄与が期待できる．検診受診率に関しては，便潜血検査免疫法による検診に加えて，画像診断法としてTCSと同様にCTCが検診項目に加えられるようになれば受診率50％達成の推進力となる可能性がある． |
|
| Theme | CT Colonography 2019 -- Recent Advances, Current Status and Its Evaluation as a Modality for Organized Cancer Screening | |
|---|---|---|
| Title | The Usefulness of CT Colonography in Colorectal Cancer Screening from the Viewpoint of Improving the Colorectal Cancer Screening Rate | |
| Author | Ryoichi Nozaki | Division of Gastroenterology, Coloproctology Center Takano Hospital |
| Author | Hiromi Arima | Division of Radiology, Coloproctology Center Takano Hospital |
| Author | Tetsuya Matsumoto | Division of Radiology, Coloproctology Center Takano Hospital |
| Author | Takayuki Maezaki | Division of Radiology, Coloproctology Center Takano Hospital |
| Author | Hidetaka Imuta | Division of Radiology, Coloproctology Center Takano Hospital |
| Author | Kazutaka Yamada | Division of Gastroenterological Surgery, Coloproctology Center Takano Hospital |
| [ Summary ] | The Japanese government aims to achieve a 50 % screening rate for colorectal cancer screening and 70 % or more (target value ≥ 90 %) for work-up examinations. However, these target values have not yet been achieved. Recently, the use of either a CT colonography (CTC) or flexible sigmoidoscopy in combination with a barium enema X-ray examination has been recommended if colonoscopy is difficult to perform as a work-up procedure. The momentum for the full-scale introduction of CTC as a work-up examination for colorectal cancer screening is increasing year by year. At the present time, most work-up procedures are performed using colonoscopies but the throughput capacity is limited. On the other hand, CTC has a sufficient capacity to improve the rate of work-up examinations. Moreover, CTC can contribute to improving the work-up rate because the accuracy of diagnosis is comparable to a colonoscopy, it is less painful than a colonoscopy, the safety level is high, and it is generally accepted among examinees. However, it is uncertain whether the introduction of a CTC can lead to an improvement in the screening rate. The findings suggest that if CTC is added to the screening items (fecal immunochemical test and colonoscopy), the screening rate may improve to more than 50 %. |
|