[in Japanese]

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[in Japanese]

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[in Japanese]

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Based on the Health Enhancement Law, the responsibility for the implementation of group screening programs for cancers was given to the local municipalities in April 2008. Also, the scope of the data to be gathered and the timing of the data gathering associated with the municipality reports on the regional health status and health enhancement programs to the Ministry of Health, Labour and Welfare have changed considerably as well. In Osaka Prefecture, the Basic Prefectural Survey for the Quality Control of Screening Programs for Cancers used to be conducted approximately six months after the national survey for the Regional Health Status and Elderly People's Health Status, and this prefectural survey used to be implemented in such a manner that all the details of the thorough examinations and treatment results were included in its report. Using such survey data obtained from cancer screenings conducted for the stomach and the large intestine, we attempted to predict how the survey results would be affected by postponing the timing of the follow-up survey. We also looked at the way in which quality control must be managed in future cancer screenings. In both the group screenings and the medical examinations conducted on an individual basis, we noticed that the consultation rates for thorough examination and the cancer detection rates were both improved, and that the quality control of cancer screenings was evaluated appropriately based on detailed information, such as the results obtained from the thorough examinations and treatment findings. Concerning the results of the cancer screenings conducted in 2008 and onward, since a period longer by one year will be available for the follow-up survey, we expect that survey results will be obtained which will reflect the reality more precisely. Thus, it has been verified that a set of data suited for use as a quality control index can be obtained.

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Informed consent (IC) for transnasal esophagogastroduodenoscopy (EGD) using DVD was evaluated. The degree of comprehension was investigated using a true-false test 10 questions regarding the contents of IC taken by 156 subjects who wished to undergo transnasal EGD for upper GI cancer screening at our institute. These subjects were divided into two groups according to the IC method employed: group A (78 subjects who gave their IC based on a document) and group B (78 subjects who gave their IC based on a document and DVD). The correct answers to the test questions were explained by nurses or by DVD only in groups A and B, respectively. The change rate from transnasal to oral EGD was also compared. The comprehension score in group B was significantly higher than that in group A. The percentage of correct answers to two questions regarding the evaluation of the usefulness of transnasal endoscopy and the management of subjects under anti-thrombosis therapy was low and not significantly different in the two groups. The change rate from transnasal to oral EGD was also not significantly different in the two groups. The facilitation of the comprehension of the IC contents by means of both a document and DVD was evaluated to be useful. However, the method of obtaining IC should be further considered in relation to issues such as the evaluation of the usefulness of transnasal endoscopy and the management of subjects under anti- thrombosis therapy.

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The main symptoms of amebic colitis are bloody stool, diarrhea and abdominal pain, but patients may be asymptomatic at certain times. The number of people infected is increasing annually in Japan. We detected five cases of amebic colitis by screening colonoscopy after a healthcare examination. Of the 919 subjects (781 males, 49 ± 14 y/o) who underwent colonoscopy after a medical screening examination at our healthcare center, we found five patients (4 males) suffering from amebiasis. Four of the five patients were symptom-free, and one patient had bloody stool. The source of infection was sexually transmitted in two cases, but was unclear in the remaining three. The findings at colonoscopy included bleeding, ulcers, and erosions covered with a white layer. The cecum was infected in all cases, and the rectum was infected in three cases. Three patients were in their thirties, and the other two were middle-aged. These findings suggest that there is a possibility of amebic infection when performing colonoscopy during medical screening examinations in young asymptomatic subjects.

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