草野 健

Ken KUSANO

鹿児島県厚生連健康管理センター

Kagoshima Kohseiren Medical Health Care Centre

キーワード : abdominal ultrasonic method, cancer screening, health examination, accuracy of screening system, effectiveness

鹿児島県の腹部超音波集検は1984年に当時の県成人病予防協会（現県民総合保健センター）によって開始された．鹿児島県厚生連健康管理センターでは1994年から巡回健診の一部としての集検を開始した．また人間ドックでは胆のう検診として行っていた腹部超音波検査を，上腹部5臓器を標的とする検診として本格化した．現在では集検3万人，ドック1万人を越える受診者に対し0.06％強のがんと多数の要処置疾患を発見してきている．しかし，検診成立要件として考察すると安全性，簡便性，効率などは満たしているものの経済性や有効性に関しては検討がきわめて不十分である．さらに，腹部超音波検診は他のがん検診と異なり健康診断的性格を有しているが，生活習慣病対策としての効果についても検討が必要である．これらの検討のためには，今後は事後管理活動の強化が必要であり，腹部超音波検診に従事する医師や技師にもそのような視点・意識が要求される．

We began screening by the abdominal ultrasonic method in 1984 in Kagoshima Prefecture. In the early years, it was performed only by the Kagoshima Prefecture Association of Prevention for Adult Disease. During these years, the number of examinees was less than 20,000 anually. In 1994, KAGOSHIMA KOHSEIREN Medical Health Care Centre began circuit screening by the abdominal ultrasonic method with circuit total health examination. Since then, the number of examinees has rapidly increased to 66,943 (in 2005) anually in all of Kagoshima Prefecture. In the last several years, KAGOSHIMA KOHSEIREN Medical Health Care Centre has performed about 30,000 circuit examinations and over 10,000 examinations at the Centre. We have detected cancers at a rate above 0.06% and many other diseases needing treatment. Requirements for cancer screening are safety, convenience, economy, efficiency, and effectiveness. Screening by the abdominal ultrasonic method meets the requirements for safety and convenience, but there has been an extreme lack of studies on economy, efficiency, and effectiveness. Many researchers have studied only the accuracy of screening with abdominal ultrasonic. Moreover, screening by the abdominal ultrasonic method can be used not only for cancer screening but also for health examinations. Therefore, we should discuss its usefulness, efficiency, and effectiveness in primary prevention of lifestyle diseases. In order to study these, consequency management needs to be improved and the accuracy of all screening systems examined. Accordingly, all persons engaged in screening by the ultrasonic method must recognize these qualities and must have a strong intention to improve its usefulness and accuracy.