群馬県館林市前立腺癌検診について : 2003年度から2005年度の3年間のPSA単独検診結果  [in Japanese] PROSTATE CANCER SCREENING AT TATEBAYASHI CITY IN GUNMA PREFECTURE : RESULTS OF SCREENING WITH PSA ALONE BETWEEN 2003 AND 2005  [in Japanese]

(目的) 2003年度より基本健康診査にPSA(前立腺特異抗原)単独検診による前立腺癌検診を組み込んで行ったので,その3年間の結果について検討した. (対象と方法) 50歳以上の基本健康診査を受ける男性のうち希望者を前立腺癌検診の対象とし, PSA単独検診にて,集団検診および市内各医療機関での個別検診の2本立てで行った.年齢階層別PSAを用いた.また一次検診時に検診結果の解析の同意を文書にて得た. (結果) 2003年度の館林市の50歳以上の男性は15,303名であった. PSA検診を受けたのは, 2003年度, 2004年度, 2005年度各々11.8%, 12.2%, 12.7%でありこの3年のPSA暴露率は20.6%であった.要2次検診受診者は各々208名, 165名, 179名であり, 2次検診受診率は各々80.3%, 61.2%, 55.3%であった. 2次検診受診者のうち前立腺生検を各々123名(73.2%), 54名(53.5%), 38名(38.4%),に施行し,前立腺癌患者を各々60名, 28名, 16名見いだした.これは1次検診者の各々3.4%, 1.5%, 0.8%, 3年間では1.85%であり,初回検診を受けた人に限ると3.2%であった.病期診断を行った101名の臨床病期はStageB 86名(85.1%), StageC 9名(8.9%), StageD 6名(5.9%)だった.この101名の治療としては内分泌療法が46名(45.5%),根治的前立腺全摘除術が31名(30.7%),外照射が5名(5.0%),無治療経過観察が6名(5.9%),他院での加療希望が7名(6.3%),加療拒否が6名(5.9%)であった. (結論) 3年間で一次検診者の1.85%に前立腺癌が発見された.病期診断を行った101名のうち85.1%がstage Bであり,前立腺癌の早期加療につながった.このことが将来的な死亡率の低下につながることを期待している.

(Purpose) Since 2003, a basic health checkup has involved prostate cancer screening with prostate specific antigen (PSA) alone. We investigated the results between 2003 and 2005. (Subjects and Methods) Among males aged over 50 years who underwent a basic health checkup, the subjects were those who desired prostate cancer screening. Cancer screening with PSA alone was performed; mass screening or individual screening in hospitals in the city. We employed PSA with respect to age stratification. On the primary screening, written informed consent regarding the analysis of the screening results was obtained. (Results) In 2003, there were 15,303 males aged over 50 years in Tatebayashi City. In 2003, 2004, and 2005,11.8%, 12.2%, and 12.7% of the males underwent PSA screening, respectively. The rate of elevated PSA levels between 2003 and 2005 was 20.6%. Furthermore, 208, 165, and 179 males required secondary screening, and 80.3%, 61.2%, and 55.3% of the males underwent secondary screening, respectively. Of the males who underwent secondary screening, prostate biopsy was performed in 123 (73.2%), 54 (53.5%), and 38 (38.4%). Prostate cancer was detected in 60, 28, and 16 males, respectively. These values corresponded to 3.4%, 1.5%, and 0.8% of the males who underwent primary screening. The incidence of prostate cancer was 1.85% during the 3 years, and 3.2% in males who underwent the initial health checkup. Of 101 males in whom the stage was evaluated, the clinical stage was evaluated as B in 86 (85.1 %), C in 9 (8.9%), and D in 6 (5.9%). Of the 101 males, endocrine therapy was performed in 46 (45.5%), surgery in 31 (30.7%), external irradiation in 5 (5.0%), and follow-up without treatment in 6 (5.9%). In addition, 7 (6.3%) desired treatment in another hospital, and 6 (5.9%) refused treatment. (Conclusion) Prostate cancer was detected in 1.85% of males who underwent primary screening between 2003 and 2005. Of 101 males in whom the stage was evaluated, the clinical stage was evaluated as B in 86 (85.1 %), and the early treatment of prostate cancer was achieved. This may lead to a future decrease in the mortality rate.