日本農村医学会雑誌
Online ISSN : 1349-7421
Print ISSN : 0468-2513
ISSN-L : 0468-2513
長野県における胃癌患者についての発生生活要因, 特に食生活についての調査
その農村医学的考察
若月 俊一船崎 善三郎越川 宏一松島 松翠寺島 重信古瀬 和寛磯村 孝二
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1962 年 10 巻 2 号 p. 77-97

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From June to September, 1961, our working survey parties visited the stomach cancer patients (chiefly those proved as such by surgical operation) admitted to 22 major hospitals in Nagano Prefecture, and by the direct interview method tried to find out according to the uniform working system the environmental factors which might have something to do with the onset of that disease. As the control group we selected the 104 persons hospitalized for their circulatory disorders, especially hypertensive diseases, and investigated them in the same way. The results were analysed in various ways. To obtain urban data to be used in comparison, we conducted an identical investigation in regard to the 64 stomach cancer patients admitted to the hospital attached to the Cancer Research Institute in Tokyo. The items of inquiries were so established as to include a large variety of what have been generally regarded as causative agents' for stomach cancer and such elements in rural life as considered to have something to do with stomach diseases in general.
The analysis of such environmental factors or life factors which might the contribute to the development of stomach cancer, conducted in comparison with the control data obtained from the hypertensive group, produced the following results:
1) The stomach cancer group was recognized, in comparison with the control group, to be more correlated with poor physique. and the inheritance of cancer diseases.
2) Differing from the control group, the history of the symptoms of “stomach disorder” was significantly correlated with the d velopment of stomach cancer. These symptoms, with the 20 years' history, were significantly more frequently observed in the stomach cancer group. This fact may be said to evidence the existence of precancerous changes or so-called precursor of cancer in the clinical sense.
3) However, the proven cases of previous stomach diseases (stomach ulcer, chronic gastritis, polyp, etc. which are called precancerous changes) were not so many, contrary to our expectation, and even as late as “3 years before”, such diseases were less than 10 per cent respectively. The existence of correlation between such diseases and the Borrman's Classification, which is said to correspond to the former, was not very clear. We consider that in the development of various kinds of gastritis, stomach ulcer, etc. there would exist some common environmental factors, and there may also be the interchange of one with another among such diseases. Moreover, such factors are imagined to be working in a complex mechanism to develop stomach cancer. Such complicated circumstances might have caused us to fail in obtaining the consistent results. In this case we refrained from going too far into this problem, by quoting varied pathological theories concerning the etiology of and the interrelationship among gastritis, stomach ulcer and stomach cancer. What we should like to specially mention here is that we take the clinical standpoint in the interpretation of those categories. If we discuss such problems sometimes from pathological, sometimes from anatomical and sometimes from clinical viewpoint, confusion will be the unavoidable issue.
4) As regards the factors of eating habit, we noticed first of all “gluttony”. Especially, it was an interesting discovery that what was really important was the habit of heavy feeding practised “10 years ago “or” 20 years ago” in “status” there appeared no difference between the two groups in regard to the habit of heavy feeding. It may be because many patients, feeling their “stomach out of order”, were obliged to eat less. Anyway, the result of this survey appears to suggest that the evils of previous gluttony cannot be rectified even if they, feeling ill, restrict their feeding in consternation. Besides, it was proved to be the typical life factor of rural people.

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