Kurosawa M, Kikuchi S, Arisue T, Fukao A
Department of Epidemiology and Environmental Health, Juntendo University School of Medicine.
Nihon Koshu Eisei Zasshi. 1998 Apr;45(4):352-60.
The number of people examined in "the Japanese Stomach Cancer Examination" programs under "Health Services Law for the Aged" has not increased, and a strategy is needed to increase participation in the programs. We have thought out a plan to persuade people to the programs by using serum pepsinogen tests without changing the framework of the programs. The plan is as follows: The subjects are those who undergo phlebotomy in "the General Health Examination" programs and who do not undergo the Stomach Examination programs. Serum pepsinogen levels are measured using the sera and those with high risk for stomach cancer are persuaded to attend "the Stomach Examination" programs. To estimate the effect of the plan, we asked several local governments to complete a questionnaire on the numbers of subjects. The ratio of the number of the subjects in the plan to the number of screenees in recent Stomach Examination programs was 0.61. An increase of about 15% was expected in screenees of the Stomach Examination Programs, if 40% of the subjects in the plan were diagnosed as high risk and 60% of the high risk subjects attended the Stomach Examination programs. From the economical stand point, it was expected that detection rate would increase and that the plan did not raise the cost for detecting a patient with stomach cancer. We also conducted a questionnaire survey of those who would be the subjects of the plan. Eighty-two percent of the subjects answered that they would attend the Stomach Examination programs, if they were told that their risk of stomach cancer was high by the serum pepsinogen tests. These results seem to suggest that more people would participate in cancer examination programs when informed that their risk for cancer is high as determined by blood tests.
根据《老年人健康服务法》开展的“日本胃癌检查”项目中，接受检查的人数并未增加，因此需要制定一项策略来提高人们对该项目的参与度。我们想出了一个计划，在不改变项目框架的情况下，通过使用血清胃蛋白酶原检测来说服人们参与该项目。计划如下：对象是那些在“综合健康检查”项目中接受静脉采血但未参加胃部检查项目的人。使用采集的血清测量血清胃蛋白酶原水平，并劝说那些患胃癌高风险者参加“胃部检查”项目。为评估该计划的效果，我们请几个地方政府填写了一份关于对象人数的调查问卷。该计划中的对象人数与近期胃部检查项目中筛查对象人数的比例为0.61。如果该计划中40%的对象被诊断为高风险，且60%的高风险对象参加胃部检查项目，预计胃部检查项目的筛查对象将增加约15%。从经济角度来看，预计检测率会提高，且该计划不会增加检测胃癌患者的成本。我们还对该计划的对象进行了问卷调查。82%的对象回答说，如果血清胃蛋白酶原检测显示他们患胃癌的风险很高，他们会参加胃部检查项目。这些结果似乎表明，当人们得知通过血液检测确定他们患癌风险很高时，会有更多人参与癌症检查项目。
