Mass Screening of Prostate Cancer and its Impact on Inhabitants in Akita Prefecture, Japan

Abstract

In 2001, the Akita Medical Association started a prostate cancer (PC) mass screening project for ≥ 50-year-old male inhabitants in individual ­municipalities of Akita Prefecture, utilizing serum prostate-specific antigen. The number of examinees increased from 4321 in 2001 to 29 936 in 2006, while the annual rate of examinees per target inhabitants remained at 11.6 to 16.8 % and the fraction of repeat examinees ­increased up to 77 % in 2006. A total of 944 PCs were screened with a stage B tumor incidence of 84.1 % (range: 82.2 to 86.6 %). The annual PC detection rate was 0.95 to 1.11 % for the first 4 years, but then declined to 0.54 % in 2006 mainly due to the increase of repeat examinees. PSA mass screening is effective for the detection of early stage PC, but a further promotion is needed to mobilize the sleeping inhabitants. Indeed, the number of new PC patients in 17 major hospitals in Akita Prefecture rapidly increased after the mass screening started (3.2-fold), suggesting an enlightenment effect of the screening project on both the inhabitants and general physicians.