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Stomach and Intestine(Tokyo) Volume 16, Issue 1 （January 1981）

胃と腸 16巻1号（1981年1月発行）

Japanese English

今月の主題早期胃癌は変貌したか

主題

早期胃癌の変貌―集検の立場から Annual Change of Characteristics of Early Gastric Cancer Detected by Mass Survey 久道茂 ¹ , 白根昭男 ¹ , 菅原伸之 ¹ , 山家泰 ¹ , 池田卓 ² S. Hisamichi ¹ , A. Shirane ¹ , N. Sugawara ¹ , T. Yanbe ¹ , T. Ikeda ² ¹宮城県対がん協会検診センター ²仙台市医療センター鶴ケ谷オープン病院 ¹Cancer Detecion Center of Miyagi Cancer Society ²Sendai Medical Center Hospital pp.71-77

発行日 1981年1月25日 Published Date 1981/1/25

DOI https://doi.org/10.11477/mf.1403107904

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Abstract 文献概要
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　1960年から始まったわが国の組織的な胃集検は全国に広く普及し，現在では年間約330万人の受検者数に達している¹⁾²⁾．そして開始以来20年を経た今日，胃集検に対する学問的な評価法も確立され，疫学的評価，技術的評価，経済学的評価あるいは行政的な評価について各分野からの点検を受けている．

　もともと，胃集検の目的と意義として考えられていたものの中には，胃癌の早期発見早期治療による救命効果，無自覚性胃疾患の発見による早期の治療と管理，胃の診断技術の開発と向上への寄与，各種胃疾患の実態把握，それに公衆衛生学的意識の向上などが挙げられ，特に早期胃癌を発見すること，かつ発見胃癌に占める早期癌の割合が，一般外来でのそれと比べて高率であることが，胃集検の目的と意義の重要な評価の一つに数えられていたのである．

　We discussed annual change of characteristics of early gastric cancer detected by mass survey.

　Approximately 20 years have been passed after starting mass survey of the gastric cancer and along with a improved diagnostic ability of a primary screening (photofluorography), improved endoscopic instruments and techniques which have been used for secondary and tertiary screenings, as well as improved biopsy technique and its' prevalence which are essential for cytological and histological diagnosis, have made a tremendous progress in detecting early and minute gastric cancer. They also improved a detection of early gastric cancer of the upper portion of the stomach.

　Because of such improvement, a ratio of the early gastric cancer in operated gastric cancer has currently become about 60% and the frequency of the minute gastric cancer, which is less than 2.0cm, became 47.8%.

　Furthermore, frequency of detecting the early gastric cancer in the upper portion of the stomach is becoming over 10%. Such a high result of detecting early gastric cancer is not only due to improvement of each diagnostic technique but also to the well organized a screening system―from the screening to a complete medical evaluation and also postoperative follow-up.

　The purpose of the mass survey of the gastric cancer is to detect the cancer as early as possible and as small as possible, then alter the natural course of the gastric cancer, death, and cure it.

　To evaluate the increased survival or decreased death rate correctly, it is necessary to discuss in considering “lead time” which has been yield by mass survey.