Kuzuya K, Ishikawa H
Department of Gynecology, Aichi Cancer Center Hospital.
Nihon Rinsho. 1996 May;54(5):1441-6.
Mass screening for uterine cancer, mainly by cytological examination, has been conducted since 1962. The total number of examinees has been increasing and has remained at the same level for the last decade. The coverage rate of screening is only 16%, much lower than the target rate of screening, at present. According to the increase in the number of examinees, the mortality has fallen gradually, because the patients with cancer detected early on are increased and treated successfully with better QOL. However, there are some problems, as follows. 1) Although the coverage rate among the first-time examinee, women in their 30s and 70s are lower than the other groups, the rate of dysplasia and uterine cancer detected among them, are higher. 2) False, negative rate of cytology is relatively high. It is suggested the systemic mass screening is effective to reduce mortality from uterine cancer. It is necessary, however, to improve and certify the further efficacy of screening in reduction of mortality of uterine cancer, referring to procedures of cytology, especially for early detection of adenocarcinoma, and registration system from the point of cost-effectiveness.
自1962年以来，主要通过细胞学检查对子宫癌进行大规模筛查。受检者总数一直在增加，并且在过去十年中一直保持在同一水平。目前，筛查覆盖率仅为16%，远低于目标筛查率。随着受检者数量的增加，死亡率逐渐下降，因为早期发现癌症的患者增多，并通过更好的生活质量成功接受了治疗。然而，存在以下一些问题。1）尽管首次受检者、30多岁和70多岁女性的筛查覆盖率低于其他群体，但在这些人群中检测到的发育异常和子宫癌的比例较高。2）细胞学检查的假阴性率相对较高。建议进行系统的大规模筛查对降低子宫癌死亡率有效。然而，有必要参照细胞学检查程序，特别是对于腺癌的早期检测，从成本效益的角度改进并确认筛查在降低子宫癌死亡率方面的进一步效果以及登记系统。
