title: A survey about further work-up for cases with positive sputum cytology during lung cancer mass screening in Ishikawa Prefecture, Japan: a retrospective analysis about quality assurance of lung cancer screening.
abstract: OBJECTIVE
  In cancer screening programs, performing appropriate further work-up is essential. In order to elucidate whether the further work-up for the subjects with positive screening results by sputum cytology was performed appropriately, the present study was conducted as the first large-scale thorough survey in Japan.
  
  
  METHODS
  All of the lung cancer screening records from 2007 to 2012 in Ishikawa Prefecture were reviewed. Additional investigations about the further work-up were performed.
  
  
  RESULTS
  In total, 2 234 984 people were invited to undergo lung cancer screening, and 494 424 people participated in the screening. Of these, 25 264 people underwent sputum cytology, and 68 positive cases were identified. Three of these 68 cases did not undergo further work-up, and another three cases had already been diagnosed to have lung cancer. Forty-five of the remaining 62 cases did not have suspicious chest shadows, and bronchoscopic examinations were performed in 36 cases. Seventeen of these 36 cases were diagnosed as having cancer, whereas none of the nine cases who did not receive the examination was diagnosed (P = 0.038). A bronchoscopic examination was not performed due to other medical conditions in three cases, due to the patient's refusal in another three cases and in the remaining three cases, the reasons were unknown.
  
  
  CONCLUSIONS
  The participation rate for further work-up was very high. However, there are some issues to be resolved regarding the transmission of information. With our new registered hospital system, the quality assurance of our screening program will be improved.
authors.affiliation: Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa The Lung Cancer Screening Division of Ishikawa, Prefectural Committee for Management of the Cancer Screening System, Kanazawa, Ishikawa sagawam@kanazawa-med.ac.jp.
authors.forename: Motoyasu
authors.initials: M
authors.lastname: Sagawa
authors.affiliation: The Lung Cancer Screening Division of Ishikawa, Prefectural Committee for Management of the Cancer Screening System, Kanazawa, Ishikawa Ishikawa Medical Center for Cancer and Cardiovascular Diseases, Kanazawa, Ishikawa.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: The Lung Cancer Screening Division of Ishikawa, Prefectural Committee for Management of the Cancer Screening System, Kanazawa, Ishikawa Ishikawa Health Service Association, Kanazawa, Ishikawa Kanazawa Medical Association, Kanazawa, Ishikawa, Japan.
authors.forename: Chika
authors.initials: C
authors.lastname: Uotani
authors.affiliation: Ishikawa Health Service Association, Kanazawa, Ishikawa.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kibe
authors.affiliation: Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa.
authors.forename: Makoto
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Machida
authors.affiliation: Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa.
authors.forename: Nozomu
authors.initials: N
authors.lastname: Motono
authors.affiliation: Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa.
authors.forename: Sumiko
authors.initials: S
authors.lastname: Maeda
authors.affiliation: Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa.
authors.forename: Katsuo
authors.initials: K
authors.lastname: Usuda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy / Q000706:statistics & numerical data; D003581:Cytodiagnosis / Q000379:methods; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D013183:Sputum / Q000166:cytology*
keywords: bronchoscopic examination; cancer screening; further work-up; quality assurance; sputum cytology