職域胃集団検診の特殊性

Characteristics of Gastric Mass Survey in Business Circles

はじめに

　胃集検が胃癌の早期発見に果した意義は大であるが，結核検診と基本的に異なる問題は，希望検診という被検者の自白意志によらざるを得ない集団検診であることで，かつ全国的に集検人口が増加し，100万人に達しているとは言え，結核に比べるとまだ規模が小で，体系も不完全なことである．胃集検の場では，集検管理が地域集団より職域集団において，質量ともに比較的よくまとまって実施されているので，職域集検の特殊性を地域集団と対比しながら検討してみる．鹿児島県では，昭和36年以来，間接4枚法による検診車集検を行ない，44年度まで約9万名に達し，検診車3台，年間3万名の規模で現在実施している．

　鹿児島県における集検受診者の中に占める職域集検数を検討してみた．昭和44年度の集検実施者数は2万6千名で35歳以上人口80万人の約3％，40歳以上人口の4.3％に相当するが，地区別割合は，町村34％が多く，離島住民21％で，市街地住民22％および職域が23％であり，地城集検が3/4を占め，職域集検数は全受診者のほぼ1/4に相当する．

　Characteristics of gastric mass survey in the business circles were determined by its results performed in Kagoshima Prefecture for the past ten years.

　Three-fourths of the examinees were from the general population and one-fourth from the business circles. The age distribution curve of the latter had the peak between forty and fifty. The percentage of people who underwent gastric mass examination every year as well as of those who had no subjective complaints were higher in the business circles.

　The percentage of referral for thorough examination was lower but that of thorough examination actually performed was higher in the business circles.

　Higher detection rate of early gastric cancer was noted in the business circles though that of gastric cancer in general was rather low. No remarkable difference was seen in both of groups in the detection rate of gastric and duodenal ulcers, nor was there much difference in that of gastric polyp.

However, remarkably high ratio of duodenal ulcer versus gastric ulcer was observed in the business circles.

　Owing to long-term follow-up, higher survival rate of gastric cancer was elucidated in the business circles It was also found that survival rate was much higher. in the group of mass examination than in that of the out-patient clinic.