title: [Current problems in mass screening for breast cancer].
abstract: As the trend in the incidences of morbidity and mortality from breast cancer in Japan has been going up in recent years, mass screening for breast cancer is being undertaken on a nationwide scale. In Tokushima prefecture, 111,571 women (49,319 in actual number) were subjected to mass screening with physical examination from 1970-1984. In 116 including 26 cases of so-called "interval cancer", breast cancer was detected. Those with cancer detected by screening were in the earlier stage of the disease as compared to those diagnosed through regular medical care at our out-patient clinic during the same period. In the breast cancers detected by screening, the classifications of tumor size and lymph node involvement were not significantly different among the initial screening cases, subsequent screening cases and interval cases. The detection rate was 0.08% of total examinees, having 0.13% in the initial screening and 0.04% in the subsequent screening. The cancer was detectable mostly in patients aged over 60 and there were few cases in the younger generation. Repeat examinees accounted for 55.8% with an annual increase, but the proportion of initial examinees remained unchanged. Women in their 30s and 40s accounted for about 64.2% of all examinees. The results suggest that procedures such as inspection and palpation are useful for early detection of breast cancer among Japanese women. It is important to emphasize the following items for further improvement in our program, older women should be encouraged to actively participate in the screening, and percentage of initial examinees should be increased. Furthermore, the current objectives of mass screening for breast cancer are: to determine an appropriate screening survey method, to organize an adequate follow-up system for women with abnormal findings, and to educate the examinees in breast self-examination.
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007564:Japan; D008403:Mass Screening; D008875:Middle Aged; D010173:Palpation