In places such as Osaka or Tokyo, which are the most densely populated cities in Japan, detection methods suitable for smaller places are not fast enough. In Osaka alone there are 2, 000, 000w omen possibly eligible for government-directed mass-screening using cytology;but it is impossible under present circumstances to screen them all. Therefore since December 1968 we have been using the private surgeries of about 800 local gynaecologists, scattered evenly over Osaka Prefecture.
However, even after five years we have made only minimal progress.-Only 22, 258 have been checked by this method. How can we improve on this? Conclusions were:If we consider that a working year is only actually 10 months, and that a working month is only actually 20 days, and that a working week is only actually five days, then even so, if 800 gynaecologists every working day screened 5 people using cytology they could all individually screen 1, 000 per year. Thus, the yearly grand total could be 800, 000. And this number is larger than 600, 000 that is CAI (Cytology Activity Index) 300 in Osaka.
If we worked on the basis suggested by statistical averages, we may find that only 60, 000, i. e. 10%, would need to be re-checked at hospital. This is not an impossible number, as we have over 140 hospitals, and they individually could re-check 3 persons per day very easily. Thus, if 140 hospitals each re-checked 3 persons per day, this would mean 60 persons per month, and 600 per year at each individual hospital. Thus the grand total could be over 80, 000, which is more in fact than suggested in this report.
And this is still a workable number.
However,
WHO can work to decrease the number from 600, 000 to 60, 000? Clearly the establishment of a public Cytology Center is the first and greatest essential for determining the present and future development of uterine cancer detection using cytology.
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