子宮がん施設検診の問題点 ――検診受診者の利便性をはかるための検診の広域化と長期化―― | Problems with Mass Screening for Cervical Cancer at Medical Facilities

〔原　　著〕

子宮がん施設検診の問題点
――▽検診受診者の利便性をはかるための検診の広域化と長期化▽――

森村　　豊^1,2)，添田　　周^2,3)，寅磐　亮子²⁾
佐藤美賀子²⁾，伊藤眞理子²⁾，高橋　一弘²⁾
菅野　　薫²⁾，鈴木　　仁²⁾，山田　秀和³⁾
佐藤　　章³⁾

¹⁾慈山会医学研究所付属坪井病院婦人科
²⁾福島県保健衛生協会
³⁾福島県立医科大学産科婦人科学講座

（受付　2006年6月26日）

Problems with Mass Screening for Cervical Cancer at Medical Facilities

YUTAKA MORIMURA^1,2), SHU SOEDA^2,3), RYOKO TORAIWA²⁾, MIKAKO SATO²⁾,
MARIKO ITO²⁾, KAZUHIRO TAKAHASHI²⁾, KAORU KANNO²⁾, HITOSHI SUZUKI²⁾,
HIDEKAZU YAMADA³⁾and AKIRA SATO³⁾

¹⁾Department of Gynecology, Tsuboi Cancer Center Hospital, Koriyama
²⁾Fukushima Health Preservation Association, Fukushima
³⁾Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima

要旨: 子宮がん集団検診における施設検診は，多様な生活様式を有する現代女性にとって検診受診の機会が増加し，受診率の上昇が期待された。ところが施設検診の受診者の増加がみられず，検診効率の低下が懸念される。原因として，受診可能な施設や期間が限定され，受診者の利便性が図られず，受診を見送っている人々の存在が考えられる。子宮がん検診の実施要項は福島県では各市町村が設定している。各自治体別の施設検診の受診条件を明らかにし，受診者の利便性と受診率に関して検討した。 2005年度に福島県の各自治体の，検診可能な施設の広域性と検診が可能な期間について調査し，受診率を比較した。検診が可能な施設を居住地内に限定した町村は36で，その検診対象人口は94,419人，受診者は3,701人，受診率は3.92% にとどまった。これは，近隣の市町村でも受診可能とした28町村の対象人口78,537人で受診者が5,094人，受診率6.49% に比して有意に低かった。受診可能期間が1月未満の26自治体の検診対象者が60,626人で受診者数は2,847人，受診率は4.70%であった。可能期間を1月以上4月未満とした34自治体の対象者が144,548人で受診者11,066人，受診率7.66%，4月以上可能な14の自治体では対象者が262,922人で受診者25,908人，受診率は9.85% であった。受診が長期に可能な自治体が受診率は有意に高かった。福島県の一部の自治体では，受診可能な施設や期間の制限がある。制限のある自治体での受診率は，広域化，長期受診可能としている自治体に比して，有意に受診率が低かった。子宮がん集団検診の効率化，特に受診率の向上のためには受診可能な地域の広域化と期間の延長による「いつでも，どこでも受診できる」体制の確立が肝要である。

索引用語: 子宮がん施設検診，受診率の向上，利便性，受診可能施設，受診可能期間

Abstract: Although mass screening has reduced the mortality from cervical cancer, the participation rate has not increased over this decade. To find the reason for this stagnation, we investigated how the cervical cancer mass screening at medical facilities is performed in the 90 municipalities in Fukushima Prefecture. With the exception of 10 urban areas as well as 16 towns and villages where cervical cancer mass screening is performed only on mobile screening buses, the 64 municipalities were divided into 2 groups: (1) 36 where the examinees are allowed to undergo the screening only in their own municipalities and (2) 28 where the examinees are allowed to undergo the screening in both their own and neighboring municipalities. In the 1st group, of 94,419 eligible women, 3,701 underwent the screening, with the participation rate 3.9%. In the 2nd, of 78,357 eligible women, 5,094 underwent the screening, with participation rate 6.5%. The difference was statistically significant. According to the screening period, 74 municipalities were divided into 3 groups: (1) 26 where the screening period is 1 month, (2) 34 where it is 4 months and (3) 14 where it is more than 4 months. In the 1st group, of the 60,626 eligible women, 2,847 underwent the screening, with participation rate 4.7%. In the 2nd group, of the 144,548 eligible women, 11,066 underwent the screening, with participation rate 7.7%. In the 3rd group, of the 262,922 eligible women, 25,908 underwent the screening, with the participation rate 9.9%. The differences were statistically significant. These findings show that the stagnation in the rate of participation in cervical cancer mass screening at medical facilities is due to limiting the screening to both local medical facilities and short periods. The rate will rise if the examinees are allowed to undergo the screening in wider areas during longer periods.

Key words: mass screening for cervical cancer, participation rate, screening in wide areas, screening during long periods