RESULTS AND SOME PROBLEMS IN MASS SURVEY FOR GASTRIC CANCER

A mass survey for stomach cancer was performed in Gunma Prefecture since ten years ago. The gastric mass survey has been called the Gunma-Method and 258, 090 cases have been examined.As the primary screening test, Shichijo's reaction (a non-specific, biological test for gastric cancer) was adopted, combining with indirect radiography and stomach complains of the patients.From this survey, 620 cases of gastric cancer including 134 cases of early gastric cancer were detected. The detection rate of the former was 0.24% and that of the latter was 0.052%. About 25 per cent of the cases received the primary screening survey were needed the more detailed examination, and this percentage was a little higher than that of other screening methods reported by others in Japan.In an early period of our survey, the primary screening test was consisted of the patient's complains and Shichijo's test without radiography. The recent screening test including the indirect radiography, however, made a significant improvement of the detection rate, namely, the rate of gastric cancer was 0.29% and that of early gastric cancer was 0.065% in the recent survey.Shichijo's reaction had been developed to detect gastric cancer and had given notice that in gastric cancer the positivity rate was much high (8090%). But in the early gastric cancer detected in mass survey, the positive reaction accounted for 28 of the total 118 cases (23.7%), that was significantly lower than those in out-patient clinic.Therefore, this reaction alone was not satisfactory for the screening test. It should be adopted, however, as a supplementary examination, since gastric cancer in the positive cases of this reaction was detected ninetimes as many as in the negative cases. In the types of gastric cancer in cases of mass survey, type II c (depressed type of early gastric cancer) was observed mostly (60%). Type I (protruded type), type IIa (elevated type), type IIa-IIc and type III (excavated type) were observed a little and their each percentage were only 10%. In advanced gastric cancer, Borrmann III type was observed mostly (60%) and Borrmann II type 20%. Borrmann I and IV type were only 10% each other. In ages, the cases of gastric cancer in the mass survey were detected mostly in the fifth decade, and interestingly, in much older age of the sixth decade in out-patient clinic. The five-year survival rate of gastric cancer in the mass survey showed better prognosis than in out-patient clinic, that is, in mass survey the five-year survival rate of early gastric cancer was 97% and of advanced gastric cancer was 45.6%; in out-patient clinic the former was 91% and the latter 16%.Since 1968, the statistical death rate by gastric cancer has been lowered in Gunma Prefecture. The decline of this death rate might be due to the results of this mass survey.