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.
Highlights
In Japan, there is free physical checkup 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 selfpaid check-up programs
Lowgrade cervical abnormalities were seen in 31 cases: 28 cases were classified as low-grade squamous intraepithelial lesion (LSIL) and 3 as high-grade squamous intraepithelial lesion (HSIL), 2 were atypical squamous cells of undetermined significance (ASC-US)
Summary
Cervical intraepithelial neoplasia typically develops into invasive cancer over a 10-year period and apparent cases of rapidly progressive cervical cancer are likely to be among women who have escaped screening and proper follow-up [1,2,3,4,5,6]. The cervical smear (Papanicolaou, Pap smear) is a routine screening test used for the detection of early cervical abnormalities, namely precancerous dysplastic changes of the uterine cervix [1,2,3,4,5,6]. Organized screening programs for cervical cancer using the cervical smears have been shown to be effective in decreasing mortality and incidence from the disease [1,7]. Together with transvaginal ultrasonography for detection of ovarian and uterine tumors, a routine cervical screening reduces the probability of developing gynecological malignant diseases. In many countries, undergoing cancer screening is not mandatory but voluntary. In Japan, there are 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
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