Morimoto Tadaoki, Okazaki Masatoshi, Endo Tokiko
Department of Adult and Gerontological Nursing, School of Health Sciences, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan.
Breast Cancer. 2004;11(1):73-81. doi: 10.1007/BF02968007.
In Europe and the United States, the proportion of women receiving mammographic screening for breast cancer has increased to 60-80%, resulting in an increase in the detection of early-stage cancer and a reduction in the mortality rate. The objectives of breast cancer screening have thus already been achieved there. In Japan, both the incidence and mortality of breast cancer have increased recently. Breast cancer screening has long been performed by clinical breast examination (CBE) alone. A reduction in the mortality of breast cancer cannot be expected from CBE. Mammographic screening for breast cancer was recommended in a notification issued by Ministry of Health, Labour and Welfare in 1999. An important aspect of mammographic screening is quality control. The Central Committee on Quality Control of Mammographic Screening(Central Committee)was organized by six screening-related societies, and attempts have since been made to establish a quality control system. Both the social recognition of the Central Committee and its cooperation with the "Quality Control Committee " of each community will become important. The cover rate of nationwide breast cancer screening by CBE alone is 12-13%, while the implementation rate of mammographic screening is presently very low and its cover rate is considered to be about 2%. With such a low cover rate, it is absolutely impossible to reduce the mortality of breast cancer. To achieve this, the administration and clinicians will be required to cooperate with each other to increase the spread and cover rate of high-quality mammographic screening.
在欧美，接受乳腺癌钼靶筛查的女性比例已增至60%-80%，这使得早期癌症的检出率上升，死亡率降低。因此，乳腺癌筛查的目标在那里已经实现。在日本，乳腺癌的发病率和死亡率近来均有所上升。长期以来，乳腺癌筛查仅通过临床乳房检查（CBE）进行。仅靠CBE无法期望降低乳腺癌死亡率。1999年，厚生劳动省发布通知，建议进行乳腺癌钼靶筛查。钼靶筛查的一个重要方面是质量控制。钼靶筛查质量控制中央委员会（中央委员会）由六个与筛查相关的学会组成，此后一直在努力建立质量控制体系。中央委员会的社会认可度及其与各社区“质量控制委员会”的合作都将变得至关重要。仅通过CBE进行的全国性乳腺癌筛查覆盖率为12%-13%，而钼靶筛查的实施率目前非常低，其覆盖率约为2%。在如此低的覆盖率下，绝对不可能降低乳腺癌死亡率。要实现这一目标，行政部门和临床医生需要相互合作，以提高高质量钼靶筛查的普及程度和覆盖率。
