有病率と年間罹患率（発生率）からみた胃癌の自然史―特に受診間隔決定のために

Natural Progression of Gastric Cancers from the Viewpoint of Morbidity Rate and Rate of Occurrence, with Special Reference to Intervals between Visits

要旨　現在の検査法で発見しうる有病率と年間罹患率（発生率）より，発見可能な早期癌のstageから愁訴のため医療機関を訪れる直前までの罹病期間は早期癌では少なくとも3.5年，進行癌では少なくとも1.3年と推定され，丁寧な細径panendoscope検査で胃癌なしと診断されたものには3年の保証期間を与えることができる．ただし，5～10％存在するスキルスとその類似疾患は除く．また，50～69歳の健康人6,498人に直接X線検査と細径panendoscopeを併用した成績を胃集団検診の全国集計と比較すると，早期癌の発見率について，男性の場合で全国集計1に対し，細径panendoscopeでは13発見することになる．胃集団検診方法の改善が急がれねばならない．

　We calculated the interval that would elapse from the time of earliest possible diagnosis to the patient visiting with a complaint. This was based on the morbidity rate obtained by the use of small-diameter panendoscope and the occurrence rate. In the case of early cancer, the period was between 3.5 years at the shortest. In the case of advanced cancer, 1.3 years, also at the shortest.

　It was found that those diagnosed as healthy by small-diameter panendoscopy could be guaranteed a 3 year period before their next visit, except in the case of 5-10％ with scirrhus carcinoma or similar.

　6,498 healthy people, between 50 and 69, were examined by x-ray or small-diameter panendoscope. The detection rate for males was 1.67％, for females 0.91％. The parcentage of early cancer detected was 73％. Compared with national gastric mass screening information, with reference to early cancer in males, the aforementioned result at the Tokyo Metropolitan Cancer Detection Center was 13 times more successful in detection than the national survice. This would suggest that improvement and refinement of national mass screening is long overdue.