視触診による乳癌検診の効果 Effectiveness of Breast-Cancer Screening by Inspection and Palpation

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視触診検診の効果をみるため, 1982年から1998年に手術を行った原発性乳癌1,275例について, 乳癌検診歴, 病期分類, 予後について調査を行った。過去に検診歴のなかったもの796例 (62.4%), 検診歴のあったもの479例 (37.6%) であった。早期乳癌の割合は, 前者が342例 (43.0%), 後者が281例 (58.7%) で有意差がみられた (p<0.001) 。次に検診歴を有する479例を検診発見癌183例, 過去に検診歴1~2回で自己発見のもの185例, 3回以上のもの111例の3群に分け早期率をみると, それぞれ56.8%, 57.3%, 64.0%であり差異がみられなかった。検診歴の内容により進行度に差がみられなかったので, 検診歴のある症例とない症例の2群に分け, 累積生存率をみた。5年では, 検診歴のあるもの96.3%, ないもの85.4%であり, 10年ではそれぞれ90.1%, 77.0%であり, 5年・10年ともに有意差がみられた (p<0.001) 。<BR>以上により, 啓蒙活動を併用した視触診による集団検診を長年続けることにより, 検診で早期乳癌を発見する効果だけでなく, 検診歴をもつものからの自己発見による早期発見が可能となり, 地域における乳癌死亡の減少に役立つものと思われた。

In order to determine the effectiveness of breast-cancer screening by inspection and palpation, we investigated 1, 275 cases of primary breast cancer that had been surgically treated in 1998. We examined the history of breast-cancer screening, the stage classification at diagnosis and the prognosis. There were 796 cases (62.4%) with no screening histories, and 479 cases (37.6%) with screening histories. Among the cases of early-stage breast cancer, 342 (43.0%) had no screening histories and 281 (58.7%) had had screening experiences - a significant difference (p< 0.001).<BR>We then divided the 479 cases with screening histories into 3 groups : 1) 183 cases of breast cancer detected by screening ; 2) 185 cases in patients with 1 or 2 screening experiences who had detected the abnormalities by themselves and 3) 111 cases who had been screened at least 3 times. The percentages of early-stage cancers were 56.8%, 57.3% and 64.0% respectively - a difference that was not significant.<BR>Since the screening histories made no difference to the degree of cancer progress, the cases were divided into 2 groups - with and without screening histories - in order to study the cumulative survival rates. Among patients surviving for 5 y, 96.3% had screening histories and 85.4% had no screening histories ; the corresponding figures for 10 y survival were 90.1% and 77.0%. The differences for both 5 - and 10-y survival were significant (p<0.001).<BR>We consider that mass screening by inspection and palpation, together with education over a number of years, is useful for detecting early breast cancer, as it increases the chances of patients detecting early cancers by themselves. Eventually it should reduce the number of deaths due to breast cancer in our area.

収録刊行物

  • 日本乳癌検診学会誌 = Journal of Japan Association of Breast Cancer Screening

    日本乳癌検診学会誌 = Journal of Japan Association of Breast Cancer Screening 9(2), 205-209, 2000-06-20

    Japan Association of Breast Cancer Screening

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各種コード

  • NII論文ID(NAID)
    10013224934
  • NII書誌ID(NCID)
    AN10398771
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    09180729
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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