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PubMed1992

[Mass-screening for ovarian cancer by means of transvaginal ultrasonography--study on size of ovary to select subjects requiring second screening].

Mass-screening for ovarian cancer by means of transvaginal ultrasonography has been performed in Aomori Prefecture since 1989. To select appropriate candidates to receive the second screening, the size of 44 normal ovaries removed by surgery and was measured studied on 10,692 ultrasonic pictures recorded on a VTR. The results were as follows: (1) All 44 ovaries were under 40mm. (2) In 3,806 (35.6%) of 10,692 women at the first screening, their ovaries were detected by ultrasonography. This detection rate was higher in young subjects and in the luteal and menstrual phases than in others. (3) Of these ovaries, 1,303 (34.2%) were under 19mm, 1,891 (49.7%) were 20-29mm and 614 (16.1%) were over 30mm in size. (4) The second screening was performed in 472 of the 614 women, and the size of the ovaries in 83 (17.6%) of them was under 29mm. (5) The frequency of ovarian size exceeding 40mm at the second screening, was 12.5% of the 30-39mm diameter group and 48.0% of the 40-49mm group at the first screening. There was no malignant tumor in the former, but there were one pre-malignant and one malignant tumor in the latter. These results indicate that the second screening should be performed for women having ovaries over 40mm in size.

Adult↗
PubMed1986

[A population survey on mass screening program for gastric cancer. Part 2. Why don't they receive mass screening examination?].

The attitude of non-examined residents to a mass screening program for gastric cancer has been surveyed by a self-administered questionnaire among 3660 residents in a small town near Kitakyushu City. Among 1159 subjects who had not received any type of examination during the past 3 years, the answers of 638 subjects who completed the questionnaire were analyzed in this study. Reasons for not being examined were classified into 4 types; "unnecessary", "rejected", "inconvenient" and "others". The most frequent reason for not taking part in the screening program was "inconvenient" which means that there were some difficulties for them to participate in the program even if they wanted to. This reason was followed by "unnecessary" and "rejected". "Inconvenient" was the main reason for not being examined among people in their forties and fifties and/or among those who have jobs. Among elderly people, "unnecessary" had the highest frequency. "Rejected" was the least important reason in all age groups. In each age group "rejected" was found more frequently among females than males. As the type of reason for not being examined was different among groups, it is essential to work out different countermeasures for each group in order to raise the participating rate.

Adult↗
PubMed1983

[Neonatal mass-screening for congenital adrenal hyperplasia due to 21-hydroxylase deficiency. II. A pilot neonatal mass-screening study in the west of Shizuoka Prefecture, Japan].

Using a simplified radioimmunoassay method for "Disc-17 alpha-hydroxyprogesterone (Disc-17-OHP)", a pilot neonatal mass-screening study for 21-hydroxylase deficiency was performed in the West of Shizuoka Prefecture for a period of 19 months. During this period, 20,975 neonates were studied, and the mean value and S.D. of "Disc-17-OHP" values were 21.1 and 9.65 pg/disc, respectively. We tentatively decided the 99th-percentile value as a recalling point, and 219 neonates (1.04%) were the candidates for recall by this criteria. One hundred thirty-six neonates out of these 219 candidates who responded to recall were evaluated by physical examination, family history and measurements of plasma electrolytes, 17-OHP and 21-deoxycortisol values as well as concentrations of pregnanetriol and pregnanetriolone in spot urine specimens. As a result, 2 infants were proved to have the salt-losing type of 21-hydroxylase deficiency (21-OHD). Approximately one half of the candidates were premature or low birth-weight infants, and at least 80% had a history of some kind of problem at delivery or in the early neonatal period. Despite the problems remaining to be solved, the present study demonstrates the feasibility and importance of neonatal mass-screening programs for 21-OHD, and suggests that the incidence of 21-OHD is probably greater than previously expected.

17-alpha-Hydroxyprogesterone↗
PubMed1975

[Organization of mass-screening for early detection of cervical cancer and its precancerous conditions. I. report: Demonstration of a computer assisted mass-screening program (Model Rostock) (author's transl)].

Gynecological mass-screening leads to a decrease of prevalence and incidence of cervical cancer and precancerous conditions. In Rostock a program for early detection of cervical cancer was developed. Organization, application of computer in this model and the expenses of a computer assisted mass-screening-program are discussed. In order to facilitate comparison between various centers, a generally accepted classification and terminology of colposcopic, cytologic and histologic findings are essential. First epidemiological results of Rostock's women are demonstrated to characterize the screened population.

Costs and Cost Analysis↗
PubMed1995

Unfavorable DNA ploidy and Ha-ras p21 findings in neuroblastomas detected through mass screening.

BACKGROUND: Urinary mass screening has been available for 6-month-old infants throughout Japan since 1985. It is still controversial as to whether the program contributes to the detection of unfavorable neuroblastomas destined to present clinically when a patient reaches an older age. DNA diploidy and tetraploidy, low expression of Ha-ras p21, and an amplified N-myc gene status relate to an unfavorable prognosis. The authors examined these biologic indicators in neuroblastomas detected by urinary mass screening. PATIENTS AND METHODS: Seventy-eight neuroblastomas detected by mass screening were studied for DNA ploidy using DNA flow cytometry, Ha-ras p21 expression using immunostaining, and N-myc gene copy number using slot-blot or Southern blot hybridization methods. RESULTS: Of 73 tumors with analyzable DNA flow cytometric results, 18 (24.7%) had diploidy (n = 7) or tetraploidy (n = 11). Twenty-eight (40.0%) of 70 tumors examined showed low-to-absent expression of Ha-ras p21. DNA diploid and tetraploid status correlated significantly with the low-to-absent expression of Ha-ras p21 (P = 0.00021). Fourteen (20.0%) of the 70 patients had both of these two unfavorable prognostic markers. N-myc amplification was not detected in 41 of 41 tumors studied. All 78 patients were alive 8-92 months after completion of treatment. CONCLUSIONS: At least 20.0% of neuroblastomas detected by mass screening have unfavorable biologic prognostic markers. These patients may benefit from early detection and immediate treatment. However, the biologic features associated with a poor prognosis are not predictive of poor outcome in individual patients, and, therefore, should not be used to justify more intensive therapies.

Aneuploidy↗
PubMed1985

Trial of early detection of breast cancer by mass screening.

Since 1977, mass screening for breast cancer has been conducted in Miyagi Prefecture, Japan. The main activities consist of itinerant screening in the communities and group screening at the workplace. In addition, examinations were also carried out at a detection center. The total number of subjects examined was 90,076 in mass screening, with 4172 (4.6%) of them requiring a second examination. The overall breast cancer detection rate was 0.12% in the mass screening. In contrast, it was 3.1% at the center examination. Cytologic studies of nipple discharge were performed on 31,833 subjects. Positive findings were seen in 4 (0.004%). The incidence of smaller tumors was higher and that of nodal metastasis was lower in subsequent examinations than in the initial screening. In the high-risk group, who also underwent mammography at first screening, the detection rate was higher than that among general subjects examined.

Adult↗
PubMed1987

Trial of early detection for breast cancer by itinerant mass screening.

Since 1977 mass screening for breast cancer has been conducted in Miyagi Prefecture, Japan. The main activities involve itinerant screening in the communities and group screening at the workplaces. In addition to the above two screenings, examinations were also carried out at a Detection Center. The total number of examinees was 94,593. Breast cancer was detected in 116 subjects (0.12%) during mass screening. In contrast, the rate was 3.1% at the Center examination. Early cancer was more frequently detected during mass screening. The cytologic studies of nipple discharge was performed in 14,314 subjects (15.3%). Positive findings were seen in five (0.005%). In the high risk group, the detection rate (0.35%) was higher than that (0.12%) among general examinees. The higher detection rate in the high risk group may have been due to both the high frequency of breast cancer and the detection of nonpalpable breast cancer by mammography.

Breast Neoplasms↗
PubMed1994

A comparative study on the efficacy of a mass screening program for colorectal cancer--comparison between cancer cases detected by mass screening and by outpatient clinics.

The present study was carried out to investigate the efficacy of colorectal screening through a comparison of the characteristics of the cancer cases detected by screening programs and by outpatient clinics. A total of 78 cases with colorectal cancer diagnosed by screening programs using fecal occult blood test in Nagano Prefecture, Japan, was collected as the index group and the same cases (one matched cases) diagnosed through outpatient clinics served as the control group for the present study. A comparison of various factors, such as tumor site, Dukes' stage, histological type, and survival rate, was made between the index and control groups. No differences were noted in tumor site and histological type between the two groups examined. The proportion of early cancer and the survival rate, however, were significantly higher in the index group than in the control group (p < 0.01). These results suggest that colorectal screening is an efficient preventive measure.

Ambulatory Care Facilities↗
PubMed1975

[Organization of mass-screening for early detection of cervical cancer and its precancerous conditions. II. report: Practical experience with a computer assisted mass-screening program (Model Rostock) (author's transl)].

Two years experiences with a computerassisted program for early detection of prestages and early cervical cancer in Rostock-city are reported. From 43.000 women invited to take part in the examination, 27.028 = 65% finally cooperated. Pathological Pap-smears were found in 134 cases (= 0,52%). Histological examination in 51 cases (= 0,2%) showed 1 Erosio vera (false positive), 9 severe dysplasia, 30 carcinomata in situ, 3 early invasions (microinvasive cancer), 3 microcarcinoma and 5 macrocarcinoma. Accessory findings were seen in 10,2%. A good organized mass-screening-system with unique nomenclature, diagnostic and treatment of cervical cancer and its prestages gives the best supposition to cut down its rate of incidence.

Adult↗
PubMed1996

[Detection of early esophageal and gastric cancers by mass screening].

The purpose of mass screening is to decrease the mortality rate of diseases which are fatal if advanced by detecting them at an early and curable stage. From this point of view, we describe here the present state of mass screening, its problems, and the future of mass screening for esophageal and gastric cancer in Japan. The conventional X-ray examination commonly used to detect esophageal cancer does not seem to be effective in detecting the malignancy at an early stage. Therefore, endoscopic examination with Lugol staining for high-risk groups is recommended for the purpose. In contrast, mass screening for gastric cancer by X-ray examination, which has been applied until now, has reduced the mortality rate of gastric cancer. At the same time, however, as various problems are pointed out, some additional investigations have been undertaken to further reduce the mortality rate of gastric cancer. As social circumstances change, and therapy as well as diagnosis for the disease improves, it is necessary to evaluate the accuracy, problems, and limits of the present system to conduct effective and functional mass screening program. The present system must be adapted it to reflect improvements and changes.

Adult↗
PubMed1985

[Trial of early detection of breast cancer by mass screening in Miyagi Prefecture].

Mass screening for breast cancer which was commenced by Miyagi Cancer Society in 1977 has been carried out on 94953 examinees. The main activities comprise itinerant screening in the communities and group screening at the workplaces. In addition to two types of mass screening, examination was also performed at the detection center. The overall breast cancer detection rate was 0.12% in mass screening. In contrast it was 3.1% at the center. Early breast cancer, however, was more frequently found in mass screening than at the center examination. The cytologic studies of nipple discharge were performed on 14314 subjects as first screening. Positive finding was seen in 5 (0.005%). In high risk group, which also underwent mammography at first screening, the detection rate was higher than that among general examinees. Method for effective procedures for detecting early breast cancer are now under study.

Adult↗
PubMed1998

[Characteristics of uterine cancer detected by mass screening].

In Miyagi Prefecture, mass screening for cervical cancer was initiated in 1961. We organized the project in cooperation with the Miyagi Cancer Society. Because cases detected in mass screening were treated earlier, their prognoses were better than cases diagnosed in outpatient clinics. A high proportion of patients detected in stage 0 and I showed improved prognoses. In 1983, the central government established the first Health and Medical Services Law for the Aged to support the project. The standardized death rate of cervical cancer in Miyagi Prefecture fell from 12.1 per 100,000 in 1961 to 4.0 per 100,000 in 1994. A case-control study revealed that women who were screened, compared with women who had no prior screening, had an odds ratio for invasive cervical cancer of 0.14. The time interval of following the last negative smear was assessed, and we found that an odds ratio for a one-year interval was 0.09. However, there still remain problems, such as the lack of a further increase in the screening rate, fixation of examinees, and increase in the incidence of young women. Uterine body cancer is one of the increasing malignancies in Japan, as well as worldwide. Its epidemiological characteristics are as follows; 1) over 50 years old, 2) infertile and irregular menstruation, 3) post-menopause, and 4) atypical genital bleeding. Screening for uterine body cancer was started in 1987 under the second Health and Medical Services Law for the Aged. The target of the screening is limited to cases with the high-risk factors above described. We reported the results of mass screening in Miyagi Prefecture, elucidated the characteristics of uterine cancer detected by mass screening, and indicated the problems.

Adenocarcinoma↗
PubMed1999

The efficiency of performing ultrasound-guided fine-needle aspiration biopsy following mass screening for thyroid tumors to avoid unnecessary surgery.

Thyroid masses are a common clinical finding, and their management remains controversial. The purpose of this study was to evaluate the clinical effect of performing routine ultrasound (US) examinations and US-guided fine-needle aspiration biopsy (US-FNAB) in the management of diffuse or nodular goiter diagnosed by mass screening. Mass screening carried out from 1993 to 1996 revealed 444 women with goiter, 322 of whom had diffuse goiter and 122 had nodular goiter. All of these patients underwent US examination, the results of which determined that 169 should undergo US-FNAB to confirm an accurate diagnosis of their thyroid tumors. Histological examinations after surgical resection revealed that 12 of the 322 patients with diffuse goiter (3.7%) and 23 of the 122 with nodular goiter (18.9%) had malignant tumors. Among the 61 thyroid tumors surgically verified, US-FNAB yielded a sensitivity rate of 93%, a specificity rate of 81%, and an accuracy rate of 90%. Insufficient aspiration was obtained from 5%. Performing US-FNAB-resulted in an elevation in the percentage of malignant tumors yielded at surgery of up to 72%. Thus, ultrasonography followed by US-guided-FNAB could be a useful routine method of evaluating thyroid tumors detected by mass screening. Moreover, a greater number of unnecessary thyroid operations can be avoided by performing US-FNAB rather than FNAB alone.

Biopsy, Needle↗
PubMed2002

Newborn mass screening and selective screening using electrospray tandem mass spectrometry in Japan.

Electrospray tandem mass spectrometry was applied to detect a series of inherited metabolic disorders during a newborn-screening pilot study and a selective screening in Japan. In our mass screening of 102,200 newborns, five patients with propionic acidemia, two with methylmalonic acidemia, two with medium-chain acyl-CoA dehydrogenase deficiency, three with citrullinemia type II, and one with phenylketonuria were identified. In a selective screening of 164 patients with symptoms mainly related to hypoglycemia and/or hyperammonemia, 12 with fatty acid oxidation disorders and six with other disorders were found. The results indicated the importance of newborn screening using this technology in Japan.

Humans↗