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Japanese

Screening for Colorectal Cancer Seibi Kobayashi 1 , Yuri Yoshii 1 , Tatsuzo Kasugai 1 1Dpartment of Medicine, Aichi Cancer Center Hospital pp.417-422
Published Date 1980/4/25
DOI https://doi.org/10.11477/mf.1403106815
  • Abstract
  • Look Inside

 Although and endoscopic diagnoses have been well established, it is most important to develop a screening system for asymptomatic population for early detection of colorectal cancer.

 From a prognostic point of view, nearly 90% of patients with Dukes' A carcinoma can survive five years. Therefore, it would be practical to aim at detecting a Dukes' A carcinoma rather than an early colorectal cancer without involving the muscularis propria.

 First of all, it is necessary to identify individuals at high risk for colorectal cancer to perform the screening efficiently.

 Rectal examination and fecal occult blood test are employed as screening method at the outpatient clinic. Rectal examination should be able to palpate a mass of the lower rectum in 50% of colorectal cancer. Fecal occult blood testing can cover the rest of the large bowel to be a site of possible bleeding.

 We have been employing “Shionogi Slide” (guaiac impregnated filter paper slide) for fecal occult blood testing. A positive rate was 94.8% (18/19) in carcinoma. without overt rectal bleeding and 71.8% (28/39) in adenoma. A false positive rate in the same period accounted for 18.2%. A positive result was yielded in 19 (95%) of 20 early carcinomas without overt bleeding.

 We recently began to apply a fecal occult blood test to mass screening of asymptomatic people for colorectal cancer in combination with gastric mass screening method. This combination yields an advantage that mass screening upper gastrointestinal series gives us an important information on the presence or absence of upper gastrointestinal diseases. We utilize Hemoccult slide which is about one-fourth as sensitive as the “Shionogi Slide”, to reduce the frequency of false positive reaction in asymptomatic population.

 It is emphasized that education to the public via mass communication and solution of many problems in performing fecal occult blood testing would be extremely important, in order to further expand this mass screening program.


Copyright © 1980, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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