Science et thérapie du cancer

Population Screening Program for Cancer of the Cervix Using a Mobile Office-Experience of 2 Million Cases

Abstract

Hiroyuki Kuramoto, Jun Miyagawa, Hiroyuki Okajima, Manichi Iida, Toshiko Jobo, Takehiko Fukami, Fumiki Hirahara, Kazushige Kiguchi, Mikio Mikami and Hiroki Nakayama

Background: To evaluate the effectiveness of population screening program for cancer of the cervix using a mobile office.
 
Methods: The screening using a bus with an examination office has been conducted since 1968 in Kanagawa Prefecture, Japan. The bus visits local communities, where people enjoy convenient opportunity to receive the detection program. The screening method was cervical cytology. Women who were recommended to have the detailed examination were controlled strictly under the Quality Assurance Committee.
 
Results: A total of 2,070,282 women, including 30.2% of women with their first visit, were screened between 1968 and 2009. Among them 13,687 (0.66%) were recommended for the detailed examination and 95.1% of them received it. Two thousands, one hundred and seventy-two of cervical cancer and 2,476 of dysplasia were detected with the detection rates of 0.10% and 0.12%, respectively. The detection rates of cancer have been decreased year by year until 0.05% in1993, and have been stationary since then. The decreasing tendency was obvious in the repeaters and higher age group. The detection rates of carcinoma in situ have been increasing up to 69.2%, whereas those of invasive cancer have been decreased. Those of dysplasia have been increased up to 0.34% in 2009 and the increasing tendency was obvious in women with first visit and age 30s followed by age 40s. However, the incidences even in the repeaters were above 0.1% in recent years.
 
Conclusion: The mobile screening program has been successful for detecting carcinoma in situ and dysplasia and will be useful for the women who live in a long distance before arriving at a permanent medical office.