Large strides have been made in primary health care and services in Jinzhai County, Anhui, sincefourth-grade health care facilities at hamlet and village levels were improved under the guidance ofthe public health organization of the county. Worthy of special note are the establishment of the health compensation system for women andinfants, introduction of premarital education programs for the young, regular checkups for pregnantwomen, regular health screenings and vaccination for infants under the age of 7. The results havebeen outstanding. Mortality rates of pregnant women, nursing mothers and babies during the perinatal period have dropped remarkably. The incidence of tetanus among the neonates has been reduced to zero. Health inquiries have found there is a high rate of cancer of the thyroid gland. As preventive measures, iodine preparations are given to primary and middle school children. Thyroidectomy has been performed on some malignant cases. Meanwhile, the spread of a clean water supply system is a major task grappled with by community health officials. Although the service area is limited yet, tap water has become available. The living environment in Jinzhai County overall has been improved to a level comparable with the PHC (?) standards recommended by the World Health Organization. Under the slogan “Creating Better Health for All the People, ” continuous effort is being madewith 2000 as the target year.
Diseases of the digestive system have been the most frequently occurring malady in Japan. Foremost among them is stomach cancer in terms of the frequency of incidence and poor prognosis. In recent years however the incidence of colorectal cancer, a well-known malignancy of plaguing. Western countries, has been increasing also in Japan apparently as a result of the change in eating habit, and is expected to become the highest of all the rates of malignancies affecting the Japanese population in due course of time. Under such circumstances, it is worthwhile to grasp the current exact status of occurrence of cancer of the digestive system in farming areas of Japan and to know the actual status of mass screening which is known to be effective in early detection of cancer, if it is to improve therapeutic results and thereby to establish ways and means of further effective cancer therapy. The recent improvement in therapeutic results of gastric cancer is due largely to energetic mass screening and/or complete medical checkup activities of participating institutions and a marked increase in early detection rate of disease.Positive performance of an extended radical operation, such as total gastrectomy or extra-gastric organ resection, facilitated or aided by the improved anesthetic technique and postoperative management as well as by advances in surgical technique for advanced gastric cancer certainly is also a contributing factor. In fact, therapeutic results obtained by some of the participating institutinons were not at all inferior to those achieved by national institutions as far as gastric cancer is concerned. Since mass screening for colorectal cancer is a formidable task apparently beyond each private institution's capacity and since, because of the anatomical position of a lesion, it may occasionally be difficult to have examinees cooperate, the mass colorectal survey system generally was less well organized and working as compared with the mass gastric survey system. However, the availability of immunologic testing for occult blood in stools, enema fluoroscopy and colonoscopy has made it possible to raise detection rates of early-stage cancer. As in the case with gastric cancer, extended radical operation has been performed positively andtherapeutic results improved markedly thanks to recent progress in diagnostic and operative techniques.