地域胃集団検診の特殊性

Problems of Gastric Mass Survey Involving Residents in Urban Areas

はじめに

　胃集団検診が本格的に行なわれるようになって相当の年月を経るに至り，今日ではその歴史の古いところ，新しいところとそれぞれの苦悩と喜びが刻まれ，一方では外来集検，職域集検など次々と新しい集検システムが続出し，胃集検のシステムについては各々の立場から一つの反省の時機に達している．中でも地域一般住民を対象とする胃集検は，それに絡む要因が複雑多岐であるため特にその感が強い．岡山県では昭和38年度より検診車による一般住民を対象とした地域集検が始り，そのシステムの概略はいわゆる岡山方式にそって終始一貫して行なわれてきたものである．すなわち，40歳以上を対象とし，精検は県医師会，県衛生部，岡山大学で定めた精検委嘱機関（昭和45年現在66施設指定）が行ない，これに各保健所が加わって要精検者と各医療機関との連絡を保ち，事後管理と成績の収集を行なっているものである．このようにして実施されてきた岡山県の成績と経験をもとに地域集検の特殊性について考察を行なった．

　A total of 210,685 persons excepting occupational groups were subjected to mass surveys of the stomach during the period from 1963 to 1968 in Okayama Prefecture. From these surveys, 582 cases of stomach cancer were detected (0.28%). The rate of those over 40 years of age undergoing the mass survey was 6.2%. We have carried the mass examination using the x-ray mobile unit (buses equipped with indirect radiography apparatus), but in spite of the increase in number of buses available, the number of persons examined did not increase yearly as was expected.

　Follow-up study of stomach cancer was done in 7 districts in Okayama Prefecture. The five-year survival rate of stomach cancer found at the mass examination was 37.5%. Those who were alive more than 5 years had undergone the precise examination immediately after the survey and were subsequently operated on within one or two months after it.

　Various questions concerning the problems in gastric mass survey have been asked by means of questionnaire to all the public health nurses in Okayama Prefecture. The results were that not only economic as well as administrative support but also close co-operation between doctors and health nurses are most essential in carrying out successful gastric mass survey among all the residents.