| 特集名 | 大腸癌のスクリーニング | |
|---|---|---|
| 題名 | 各論 (1) IFOBTによる大腸癌一次スクリーニングの成績 b. 集検発見癌の特徴と免疫2日法の感度 | |
| 発刊年月 | 2001年 03月 | |
| 著者 | 島田 剛延 | 宮城県対がん協会がん検診センター |
| 著者 | 樋渡 信夫 | 東北大学医学部第三内科 |
| 著者 | 森元 富造 | 仙台赤十字病院内科 |
| 著者 | 熊谷 裕司 | 仙台赤十字病院内科 |
| 著者 | 山下 和良 | 仙台赤十字病院内科 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Average-risk colon cander screening | |
|---|---|---|
| Title | Characteristics of colorectal cancer detected by mass screening and sensitivity of two-day immunological fecal occult blood tests | |
| Author | Takenobu Shimada | Cancer Detection Center of Miyagi Cancer Society |
| Author | Nobuo Hiwatashi | The Third Department of Internal Medicine, Tohoku University School of Medicine |
| Author | Tomizo Morimoto | Department of Internal Medicine, Sendai Red Cross Hospital |
| Author | Yuji Kumagai | Department of Internal Medicine, Sendai Red Cross Hospital |
| Author | Kazuyoshi Yamashita | Department of Internal Medicine, Sendai Red Cross Hospital |
| [ Summary ] | To evaluate colorectal cancer screening, using a two-day immunological fecal occult blood test, we investigated the characteristics of colorectal cancer detected by mass screening and sensitivity of screening tests. Clinicopathological characteristics of 585 screen detected colorectal cancer subjects (screen group) were compared with those of 303 colorectal cancer patients with symptoms (symptom group). The rate of stage 0 and I cancer of the screen group was higher than that of the symptom group (71.8% vs 25.1%). The five-year survival rate of the screen group, measured by the Kaplan-Meier method, was significantly higher than that of the symptom group (82.5% vs 59.5%). By using a proportional hazard model with adjustment for gender, age, tumor location and histological type, the hazard ratio of death from colorectal cancer was 0.33 for the screen group versus the symptom group. Sensitivity of a single screen, composed of a two-day immunological fecal occult blood test was 64.9% However, most false-negative cases from a single screening were diagnosed by the screening examination the next year and about 75% of them were Dukes A. Therefore, if early or Dukes A cancers were excluded from the false-negative cases, the sensitivity was 86.0% or 88.7% respectively. These results suggest a reduction in mortality rates from colorectal cancer by screening and the necessity of annual screeninig. |
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