日帰りドックにおける前立腺症状問診票ならびに前立腺特異抗原による前立腺検診

Abstract

企業日帰り人間ドック健診において前立腺症状問診票および前立腺特異抗原(PSA)を用いた前立腺検診を試行し, 2次検診の追跡調査を行って結果を解析した.全検診者390名中2名(0.51%)で前立腺癌が発見され, うち1名はstage B2の早期癌であった.問診票により約25%が中等症以上の症状を示したことから, 問診票による排尿スクリーニングはドック検診においても簡便で有効な方法であると考えられた.2次検診における泌尿器科専門医の連携があれば, 常勤泌尿器科医がいない施設での前立腺検診も有効な手段であると考えられた.今回の検診では2次検診受診率が32.1%と低く, 今後は受検者教育を含めた対応が必要と考えられた

We preliminarily studied screening for prostatic diseases in one-day total health check-up by employing prostate specific antigen (PSA), international prostate symptom score (IPSS) and quality of life (QOL) index. From January 6 to March 31, 1998, a total of 390 men were included in this study, whose age ranged from 50 to 78 years with the mean of 57.5 years. The questionnaires, IPSS and QOL index, were mailed to the participants in advance. PSA (IMx: Dainapack) was measured at the end of the health check-up and the results of tests were explained on the same day. Participants who showed more than 8 points in IPSS, more than 4 points in QOL index and/or more than 4.1 ng/ml in PSA were given a referral to urologists of corresponding hospitals for further examination. A total of 116 men (29.7%) were judged to need thorough examination. Among 106 men who were referred to urologists, only 34 (32.1%) had visited the urologists by the end of July 1998. Two men (0.51% in all participants) were diagnosed with prostate cancer, 10 received some pharmacotherapy, and 2 underwent transurethral resection of prostate. The results indicate that screening for prostatic diseases in total health check-up is useful, even in an institute without staff urologists, in close association with urologists.