MASS-SCREENING FOR HEPATOCELLULAR-CARCINOMA - EXPERIENCE IN HOKKAIDO,JAPAN

Mass screening for liver cancer based mainly on abdominal ultrasound w as begun in major cities of Hokkaido, Japan, in November 1981, to enab le early detection and treatment of hepatocellular carcinoma (HCC). Se rum alpha-fetoprotein levels were also measured to minimize false nega tive studies. Examinees included those who sought liver disease screen ing as well as high risk individuals: hepatitis B surface antigen carr iers and those with a past or current liver disease, history of blood transfusion, family history of liver cancer, and more recently those w ith positive anti-hepatitis C antibodies. The examination was carried out on each Saturday and Sunday as one round, and by February 1992 48 rounds had been performed. A total of 8090 individuals were investigat ed, and HCC was detected in 91 with a detection rate of 1.12%. This ra te was 1.6% among 5684 individuals who were selected for high risk. Cu mulative rates of survival among these patients were 79.0% at 1 year, 43.8% at 3 years, 19.3% at 5 years and 15.4% at 7 years. These surviva l rates were comparable with those for the patients with HCC diagnosed during follow-up of chronic liver disease and treated at our hospital . The cost for detecting one HCC patient in this programme was Y2660 0 00 (approximately US$25 000), which was less than those for some other types of cancer in a similar setting. Considering the high detection rate in this programme, we feel that similar programmes should be enco uraged and supported.