三原 修一

Shuichi MIHARA

日本赤十字社熊本県支部　健康管理センター

Kumamoto Red Cross Health Care Center

キーワード : Ultrasound, Mass screening, Abdominal cancer, Early detection

From August 1983 through December 1988, 76,514 people received ultrasonic mass screening for the first time. Among these people, 129 (0.17%) were found to have cancer, and 73 received curative resection. The resection rates of hepatocellular carcinoma (H. C. C), gallbladder cancer, pancreatic cancer, and renal cell carcinoma were 19.0% (8/42), 78.9% (15/19), 57.1% (4/7), and 100% (38/38), respectively. The cumulative survival rate (Kaplan-Meier's method) of renal cell carcinoma cases receiving surgery was significantly higher than that of the other types of cancer.
Ultrasonic mass screening is useful for the early detection of abdominal cancer. To detect H. C. C. earlier, it seems to be important to use ultrasonography as the first step in mass screening and to follow up closely the high-risk H. C. C. group. To detect gallbladder cancer earlier, it appears essential to supervise closely asymptomatic gallbladder diseases, especially gallstone cases and gallbladder polyp cases. This means that earlier surgical treatments should be indispensable for atypical cases. In addition, those who have abnormalities but do not require surgery should undergo periodic ultrasonic examinations. In the detection of pancreatic cancer, there are many problems to be conquered. However, ultrasonic mass screening did find four resectable cases, indicating that the pancreas should be observed more carefully. In diagnosing and making prognoses for renal cell carcinoma, ultrasonic mass screening seems to have been quite effective. To detect renal cell carcinoma earlier, the kidney should be observed more carefully.
To develop and promote ultrasonic mass screening, we have to dissolve the problems such as training examiners, standardizing the screening method, and establishing management systems. We hope ultrasonic mass screening will make a great contribution to the early detection of various kinds of abdominal cancer.