Uterine Cancer Mass Screening

There are many reports on the effectiveness of uterine cervical cancer examinations performed by cytology. This is also reported in detail in "Research Report on Effective Evaluation of Cancer Examinations" (March, 1998) by a research group of the Ministry of Health, Labor, and Welfare. With this outline, and from the data by the Cancer Measures Committee of Japan Association of Obstetricians & Gynecologist, problems of uterine cervical cancer examinations which is known of its effectiveness, has been analyzed. Also, Business report of the health for elderly of the Ministry of Health, Labor, and Welfare, is compared to the data of detection rate from Tokyo Kenbikyoin Foundation and Tokyo Metropolitan Cancer Detection Center. The speaker also refers about a booklet "To expand uterine cervical cancer examinations to the 30's "which has been published by the Cancer Measures Committee of Japan Association of Obstetricians & Gynecologist in 2002, containing data from each region. According to Business report of the health for elderly of the Ministry of Health, Labor, and Welfare, the number of detection of uterine cervical cancer is in tendency of gradual decrease. The percentage of detection of uterine cervical cancer in Tokyo Kenbikyoin Foundation and Tokyo Metropolitan Cancer Detection center is decreasing as well. According to the research of Cancer Measures Committee of Japan Association of Obstetricians & Gynecologist, in the 1970, 1980, 1990's, the influence ratio of invasive carcinoma and carcinoma in situ of all ages are decreasing in Miyagi prefecture. But its influence ratio of women in their 20's are increasing, and the ratio of carcinoma in situ of women in their 30's are increasing as well. In Fukushima prefecture, the number of women over the age of 40 with severe dysplasia, carcinoma in situ and micro invasive carcinoma are decreasing or is stable, but for those who are un der the age of 39 are increasing in number. According to the research performed in Nagoya comparing the number of patients with uterine cancer of 36 and older, and 35 and younger from 1987～1991 and 1992～1996, the influence ratio of invasive carcinoma of 35 and younger has increased to 2.3% to 8.1%. The ratio of carcinoma in situ has increased to 17.5% to 29.7%. In Niigata prefecture, the influence ratio of uterine cervical cancer of women in their 20's and 30's has definitely been increasing within the ages, whereas the medical examination rate of this age has been very low. In Shimane prefecture, the detection rate of cervical cancer by a medical examination was 32%, but has lowered to 17% by 1996. 12.4% of the patients of carcinoma in situ are in their 20's, and 88% of patients of uterine cervical cancer were carcinoma in situ, but there were none that were detected by a medical examination. The research in Ibaraki prefecture showed the number of patients with findings by uterine cervical cytology was nearly the same with those of 30 and older. 1. The effectiveness of uterine cervical cancer examination performed by cytology is definite. 2. Those who get uterine cervical cancer examination tend to be low throughout Japan. The reason maybe because of its economical side, such as the general financing of the national subsidy or depression. Or it may be because of the effects by some media saying about the unnecessariness of examinations. 3. The functions of medical examinations are lowering by the decrease of the detection rate by the fixation of examinees, and the increase of the influence ratio of the young, who are below the subject age of examination. There is a need to look up those who have not had examinations in a national level, and a need to prevail examinations to the young.