地域逐年胃集団検診の成績

Results of Regional Gastric Mass Survey on the Year-to-Year Basis

はじめに

　昭和37年以来，一般住民および職域に対して胃集団検診を行なってきたが，方式の確立されない過去においても，また流行化した現在においてもなお多くの問題があり，所期の目的を達するには道は遠い．逐年胃集団検診の目的は特定集団の同一人を毎年1回継続して検診し，1）新しく発生する胃癌を早期のうちに発見する．2）早期胃癌の経過が比較的長いものが多いことから，前年検診の見逃し胃癌のひろいあげがその主なものである．しかし，現状では逐年検診により100％に継続検診することは極めて困難で，殆んど不可能に近い．

　筆者らは昭和41年以来，医療施設に恵まれない2ヵ町をモデル地域に指定して，“町ぐるみ逐年胃集検”と銘うって，町当局との緊密なる提携のもとに続けてきた．しかし，5年経過した今日，当初の理想とはおよそかけ離れた結果に反省させられると同時に，今後の困難な問題に当惑している実状である．

　本集検は中国新聞社会福祉事業団の協力により集検車，材料の提供を受けて無料で行なったものである．

　Results of gastric mass survey conducted for five years in the town M and for three years in the town K have been reported.

　1) Gastric cancer has been detected in 18 cases, including four (22.2%) of early cancer (Ⅱc, 1; Ⅱc+Ⅲ, 2; and Ⅰ, 1). Of the remaining 14 cases of advanced gastric cancer, one presented a Ⅱc-simulating finding, three closely resembled type and still another very much like a type. These were all slight in their infiltration, only partly reaching pm. All of 14 operated patients are alive, and except for one, they are all in good health and enjoying normal way of life. The longest survival time is 4 years and 10 months.

　2) Of 18 cases of gastric cancer thus detected 7 had previous experience with gastric mass survey; three did not undergo subsequent thorough check-up in spite of the advice to do so; the remaining 4 had been pronounced as normal one year before.

　3) The number of examinees in both towne has begun to decrease since the second year of survey institution.

　4) The percentage of actually undergone thorough check-up in the first year was 65.7 in the town M and 67.7 in the town K. A far higher percentage, 83.4% in M and 87.8% in K, is now achieved since the initiation of thorough check-up by means of gastrofiberscope done at the place of examination.

　5) In the town of M, where gastric mass survey has been conducted for five years running, the whole number of persons having undergone it was 2,874, and the actual number of examinees was 1,500. Of these, 781 persons have undergone it only once (51.7%); 333 persons, twice (22.0%); 119, three times (13.1%); 130, four times (8.6%); and only 62 persons were examined five times (4.1%).

　6) On the basis of the present study, it has further been commented on consecutive gastric mass survey as it really ought to be.