OJOG  Vol.1 No.2 , June 2011
Evaluation of a public expense-covered gynecologic screening program in Japan 2005-2009
ABSTRACT
Introduction: In Japan, there is free physical check-up programs of cancer screening, by which asymptomatic participants undergo a medical examination at public expense. The present study aims to describe their gynecologic findings and compare them with the literatures reported from general hospitals and self-paid check-up programs. Methods: Medical records of Japanese women, who underwent gynecological examinations at public expense between 2005 and 2009, were retrospectively reviewed. Results: Of the cervical smears from 2850 women aged 21 - 82 years, 33 (1.1%) were classified as dysplastic and malignant changes: 28 of low-grade squamous intraepithelial lesion (LSIL), 3 high-grade squamous intraepithelial lesion (HSIL), 2 atypical squamous cells of undeterimined significance (ASC-US). No case of cervical squamous cell carcinoma or adenocarcinoma was found. Ultrasonographic examination detected uterus enlargements and ovary tumors in less than 1% of cases. Most of participants (98%) revealed no gynecologic abnormalities. Conclusion: Annual gynecologic screening and proper follow-up programs even against asymptomatic women may remarkably reduce the probability of (pre)malignant disease.

Cite this paper
nullTakagi, H. , Ichigo, S. , Matsunami, K. and Imai, A. (2011) Evaluation of a public expense-covered gynecologic screening program in Japan 2005-2009. Open Journal of Obstetrics and Gynecology, 1, 21-24. doi: 10.4236/ojog.2011.12005.
References
[1]   Anttila, A., Ronco, G., Clifford, G., Bray, F., Hakama, M., Arbyn, M. and Weiderpass, E. (2004) Cervical cancer screening programmes and policies in 18 European countries. British Journal of Cancer, 91, 935-941.

[2]   Bray, F., Loos, A., McCarron, P., Weiderpass, E., Arbyn, M., M?ller, H., Hakama, M. and Parkin, D. (2005) Trends in cervical squamous cell carcinoma incidence in 13 European countries: Changing risk and the effects of screening. Cancer Epidemiology, Biomarkers & Prevention, 14, 677-686. doi:10.1158/1055-9965.EPI-04-0569

[3]   Greenlee, R., Hill-Harmon, M., Murray, T. and Thun, M. (2001) Cancer statistics, 2001. CA: A Cancer Journal for Clinicians, 51, 15-36. doi:10.3322/canjclin.51.1.15

[4]   Hakama, M., Coleman, M., Alexe, D. and Auvinen, A. (2008) Cancer screening: Evidence and practice in Europe 2008. European Journal of Cancer, 44, 1404-1413. doi:10.1016/j.ejca.2008.02.013

[5]   Johannesson, G., Geirsson, G., Day, N. and Tulinius, H. (1982) Screening for cancer of the uterine cervix in Iceland 1965-1978. Acta Obstetricia et Gynecologica Scandinavica, 61, 199-203. doi:10.3109/00016348209156556

[6]   Mount, S. and Papillo, J. (1999) A study of 10,296 pediatric and adolescent Papanicolaou smear diagnoses in northern New England. Pediatrics, 103, 539-545. doi:10.1542/peds.103.3.539

[7]   Nieminen, P., Kallio, M., Anttila, A. and Hakama, M. (1999) Organised vs. spontaneous Pap-smear screening for cervical cancer: A case-control study. International Journal of Cancer, 83, 55-58. doi:10.1002/(SICI)1097-0215(19990924)83:1<55::AID-IJC11>3.0.CO;2-U

[8]   Dietrich, A., Tobin, J., Cassells, A., Robinson, C., Greene, M., Sox, C., Beach, M., DuHamel, K. and Younge, R. (2006) Telephone care management to improve cancer screening among low-income women: A randomized, controlled trial. Annals of Internal Medicine, 144, 563-571.

[9]   Lawson, H., Henson, R., Bobo, J. and Kaeser, M. (2000) Implementing recommendations for the early detection of breast and cervical cancer among low-income women. MMWR—Recommendations and Reports, 49, 37-55.

[10]   Ng, E., Wilkins, R., Fung, M. and Berthelot, J. (2004) Cervical cancer mortality by neighbourhood income in urban Canada from 1971 to 1996. Canadian Medical Association Journal, 170, 1545-1549. doi:10.1503/cmaj.1031528

[11]   Schoenberg, N., Hopenhayn, C., Christian, A., Knight, E. and Rubio, A. (2005) An in-depth and updated perspective on determinants of cervical cancer screening among central Appalachian women. Women Health, 42, 89-105. doi:10.1300/J013v42n02_06

[12]   Yabroff, K., Lawrence, W., King, J., Mangan, P., Washington, K., Yi, B., Kerner, J. and Mandelblatt, J. (2005) Geographic disparities in cervical cancer mortality: What are the roles of risk factor prevalence, screening, and use of recommended treatment? The Journal of Rural Health, 21, 149-157. doi:10.1111/j.1748-0361.2005.tb00075.x

[13]   Mu?oz, N., Bosch, F., de Sanjosé, S., Herrero, R., Castellsagué, X., Shah, K., Snijders, P. and Meijer, C. (2003) Epidemiologic classification of human papillomavirus types associated with cervical cancer. The New England Journal of Medicine, 348, 518-527. doi:10.1056/NEJMoa021641

[14]   Rocha-Zavaleta, L., Yescas, G., Cruz. R. and Cruz-Talo- nia, F. (2004) Human papillomavirus infection and cervical ectopy. International Journal of Gynecology & Obstetrics, 85, 259-266. doi:10.1016/j.ijgo.2003.10.002

[15]   Tachezy, R., Saláková, M., Hamsíková, E., Kanka, J., Havránková, A. and Vonka, V. (2003) Prospective study on cervical neoplasia: Presence of HPV DNA in cytological smears precedes the development of cervical neoplastic lesions. Sexually Transmitted Infections, 79, 191- 196. doi:10.1136/sti.79.3.191

[16]   Baseman, J. and Koutsky, L. (2005) The epidemiology of human papillomavirus infections. Journal of Clinical Virology, 32, S16-24. doi:10.1016/j.jcv.2004.12.008

[17]   Clavel, C., Masure, M., Bory, J., Putaud, I., Mangeonjean, C., Lorenzato, M., Nazeyrollas, P., Gabriel, R. and Quereux, C., Birembaut, P. (2001) Human papillomavirus testing in primary screening for the detection of high-grade cervical lesions: A study of 7932 women. British Journal of Cancer, 84, 1616-1623. doi:10.1054/bjoc.2001.1845

[18]   Levy, B. (2008) Modern management of uterine fibroids. Acta Obstetricia et Gynecologica Scandinavica, 87, 812-823. doi:10.1080/00016340802146912

[19]   Parker, W. (2007) Uterine myomas: Management. Fertility and Sterility, 88, 255-271. doi:10.1016/j.fertnstert.2007.06.044

[20]   Sankaran, S. and Manyonda, I. (2008) Medical management of fibroids. Best Practice & Research Clinical Obstetrics & Gynecology, 22, 655-667. doi:10.1016/j.bpobgyn.2008.03.001

 
 
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