| Research Abstract |
In the Takatsuki-City and Shimamoto-Cho (T/S region), the clinic-based lung cancer screening (CBLCS) program began in 1988 and the program was established in 1991 when follow-up inquiry was started for final diagnoses of abnormal findings. The program has an educational aspect that refines and advances lung cancer detection techniques in participating medical facilities of the region. If, in these facilities, all chest X-ray films were read with skill as exquisite as in the screening program, substantial cover rate of screening in the region would be kept high and prognosis of lung cancer patients in the region might be improved.
In the first study, we retrospectively analyzed the outcome of 396 lung cancer patients treated in our department. They were divided into four groups according to their residential region, i.e., T/S region or other regions (Oth) and the time of their consultation, i.e., before 1990 (early) or after 1991 (late) : early T/S, late T/S, early Oth, and late Oth. Med
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ian survival times (MST) and 5-year-survival rates (5-YSR) were compared between these groups excluding patients letected by screening programs. MSTs (weeks) were 47.4, 74.9, 45.7 and 40.9, and 5-YSRs (%) were 11.6, 23.5, 16.5 and 9.1 in the four groups, respectively. The outcome in the late T/S group was significantly better than that in any of the other groups (p=0.0184, 0.0267, 0.0363).
In the second study, to confirm the improvement in prognosis for lung cancer patients from 1985 through 1996, we investigated the numbers of lung cancer deaths in T/S region and compared it with the number in a control region {[baraki, Settsu, and Hirakata city ([/S/H region)]. In the first half of the period, mortality rate of lung cancer per 100,000 was equivalent (37.0 per 100,000) in the T/S region and in the I/S/H region (p=0.9787), but in the latter half of the period, the mortality rate was significantly lower in the T/S region (45.8 per 100,000) than in the I/S/H region (51.2 per 100,000) (p=0.0233).
The significant improvement in survival and mortality rate in the study region was probably brought about by the educational aspects of the CBLCS program through refinement and advancements in lung cancer detection techniques in medical facilities of the region. This educational enlightenment of health care practitioners at regional medical facilities should be considered as one of the important goals of a CBLCS program. Less
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