An investigation was made of the health conditions of the adult residents (age: 20-74) in an agricultural district of northern Kyushu, through a questionnaire and health examination. A total of 639 individuals responded to our investigation. Health-related habits such as alcohol drinking, cigarette smoking and exercise, the degree of obesity, and their relations with serum total cholesterol (TC) and high density lipoprotein cholesterol (HDL) were studied.
The levels of TC and HDL and lifestyles in this district were not particularly different from those in other districts of the nation. Numbers of heavy drinkers and heavy smokers were found larger in farmers than in non-farmers. Farmers got less exercise than non-farmers. Worthy of note is the fact that obesity prevalence was higher among males than females in both farmer and non-farmer groups. Mean TC levels were slightly lower and HDL levels were slightly higer in farmers than in non-farmers.
Four years after the investigation, a follow-up survey was made. Age-adjusted mean TC levels had been up by 15-17 mg/dl (p<0.01), but HDL was almost at the same level (only 1 mg/dl increase) both in farmers and non-farmers. Covariance analysis was made to assess the relations of each health-related habit and obesity with TC and HDL. The results showed obesity was positively correlated with increased levels of TC, while alcohol consumption, cigarette smoking and exercise had little bearing on TC levels. The relations with HDL levels were weakly positive for alcohol consumption, and weakly negative for both cigarette smoking and obesity. No definite association was observed between exercise and HDL levels.
These findings suggest that there is no significant difference between farmers and non-farmers with respect to health practices and serum lipids. This also suggests that once wide differences in lifestyle between the two groups have disappeared.

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During the 10-year period from January 1978 to December 1987, our department of surgery performed a total of 1, 839 surgical operations for cancer of the stomach. The surgical removal rate stood at 96.9%, and 80.2% of the patients who underwent surgery were cured. The cases of early grastic cancer accounted for 54.3%. The death rates under and after the operation were 0.3% and 0.8%, respectively.
The 5-year suvival rates for progressive cancer removal cases and cured cases are 53.9% and 74.2%, respectively.
To improve the results of treatment, improvements should be made to the method of physical examination for early detection of diseases and diagnostics, and surgical techniques. In addition, interdepartmental collaboration in therapy is called for.

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A clinical study was made on a total of 478 stomach cancer cases that had been subjected to surgery during the 12-year period from 1978 to 1989. Of the total, 34.1% were accounted for by the patients aged 70 years and above. Those old patients were divided into the two groups-those in their 70s and those in their 80s and above. The clinical cases of the two aged groups were studied in comparison with the cases of the patients aged 69 and below (65.9%). The number of early stomach cancer cases was smallest in the 70s age group. However, in this age group, advanced cancer was largest in number, metastases to lymph nodes, peritonea, and the liver were observed in many cases, and the curative resection rate was low. In the age group of 80 and above, either early cancer or advanced cancer was large in number. Apparently moderation was exercised in performing surgerical operations on the persons of advanced age. It was found that R2 lymph node dissection had been confined to 68.4% of the patients aged 80 and above, but that the curative resection rate was highest with 84.2% probably because limited lymph node metastasis. In this age group, a majority of cancers occurred at the antral region. A tendency was observed that cancer occurs less at the lesser curvature and on the posterior wall of the stomach and much more freqently at the greater curvature and on the anterior wall. Histologically, the tumor cells were mostly of a highly differentiated, localized type. Although high risk is involved in surgery in the elderly patients, many cases of stomach cancer are operable. So, it would be worth physicians' intention to risk operations while taking precautions against postoperative complications, with a view to improving the cure rate and helping the patients to upgrade the quality of life in their remining years.

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