胃集団検診における精検

Thorough Examination Subsequent to Gastric Mass Survey

はじめに

　胃癌好発年齢層をより多くスクリーニングするための基本的な要件は，そのための施設（検診車を含めて）をいかに増設するかの前に，一次スクリーニングの「かなめ」であり「眼」である「間接X線フィルムの読影」に，より多くの専門医師をいかに多く確保し得るかにかかっている．

　さらに，その「眼」が幸いによく確保されたとしても，特に現在の胃癌対策においては，二次スクリーニング以降の胃カメラ検査，X線直接撮影，ファイバースコープ検査，生検，細胞診などを常時担当し得る専門医師を，どれほどまでに確保できるかによって，一次スクリーニングの実施可能の範囲はおのずから限定される．

　胃集検がその目的とするところを達成するためには，充分な精密検査が行なわれなければならない．しかし実際には，被検者側，検者側のいろいろな都合によって，なかなか充分な精密検査が行なわれ得ないのが現状である．

　Prerequisite for successful screening of as many persons as possible beyond the age when gastric cancer is more likely to occur depends, preceding the question how to establish more institutions for this purpose, on whether or not specialists in this field can be secured in the “interpretation of indirect x-ray films” which is the eye of primary screening.

　Granting that such eyes have been secured, the extent of possible screening is still limited depending on the number of other specialists secured for the present measures against gastric cancer who are in daily charge of such examinations as direct x-ray photography, fiberscopy, biopsy and cytological diagnosis. To fulfil its original function, gastric mass survey requires subsequent thorough examination. Actually, however, such minute examination is not so often performed owing to various circumstances of both the examiner and examinee.

　As members of those who are in charge of gastric mass survey for local people who are little blessed with chances to avail themselves of the existing medical institutions for periodic check-up, the authors have investigated peculiarity and efliciency progress of thorough examination subsequent to general mass survey, based centrally on the results of gastric mass survey done for the past ten years in Miyagi Prefecture.

　It is still a great problem for the health control of regional people how to incorporate in the present medical system the organized examination procedures for early gastric cancer that are in great need of technical extension.