Nihon Shoukaki Gan Kenshin Gakkai zasshi

Ever since it was recognized that Helicobacter pylori (hereinafter referred to as Hp) was deeply associated with the onset of gastric cancer, efforts have been made to establish a new and more effective check-up approach in gastric cancer screenings toward indentifying individuals in the high-risk group using a serologic method, so that gastric cancers can be detected in the early stages. Even though there is clear evidence that the mass screening of gastric cancer by means of the ongoing radiological method has been contributing to the lowering of the mortality rate for gastric cancer, it is still necessary to make changes by introducing a new approach to the current screening method employed in gastric cancer examinations by the radiological investigation of the upper GI tract. In this age of Hp, we would like to propose a new diagnostic criterion for indentifying high-risk cases based on radiological findings on the gastric mucosa in gastric cancer screenings to be conducted in Nara Prefecture.

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Mass screening of colorectal cancer by means of immunochemical fecal occult blood test was performed at the work place over a period of 5 years. The subjects were over 40 years old and their number ranged from about 1,200 to 2,200 yearly. About 70% of the subjects underwent the screening, and 8-9% of them were identified as requiring detailed examination: 75% among them underwent the recommended examinations. Only one early colorectal cancer was found, but several colorectal adenomas larger than 2 cm in diameter were found every year. These results suggest that the mass screening is somewhat effective in preventing the occurrence of colorectal cancer. Additionally, we analyzed the past history of screening in patients who were found to have colorectal cancer in the early (23 cases) and advanced (7 cases) stages at this center over a period of 8 years. Twenty-one cases (91%) of advanced disease and only 3 cases (43%) of early disease, were found by the screening, the difference being significant (p< 0.05). All cases of advanced cancers except one had never undergone the screening, and were already in the advanced stage when visiting this center: 4 of them soon died. The remaining one, who had undergone the screening annually, was found to have stage-II cancer. It is tentatively concluded based on the results that an annual screening of this type is effective and important in preventing the occurrence of colorectal cancer.

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