Four years experience of the survey on quality control of lung cancer screening system in Japan

Although quality control is essential in mass screening system for early detection of cancer, no global method for quality control has not been established, because the mass screening system in each country is quite different from each other. At present, we have to find appropriate method for each cancer and for each country. In 2000, The Lung Cancer Screening Division (LCSD) of the Miyagi Prefectural Committee for Management of the Cancer Screening System (Miyagi PCMCSS) decided to evaluate annually whether the local governments had appropriate information to evaluate the quality of lung cancer screening systems, announcing that the results would be informed to residents. On the basis of the manual developed by the Ministry of Health, Labor and Welfare, 45 items were selected as indicators for the survey, which could be obtained easily when the screening had been conducted according to the standard method. LCSD of Miyagi PCMCSS sent a questionnaire including the 45 items to the municipalities. According to the reply to the questionnaire, LCSD rated each municipality using a 5-rank classification depend on the number of insufficient items: A: 0; B: 1-4; C: 5-8; D: 9 or more; E: no reply. As the results, 58, 3, 6, 3, and 0 municipalities were categorized in 2002 as A, B, C, D, and E, respectively. In 2003, the number of municipalities changed to 60, 7, 2, 1, and 0. In 2005, the distribution improved more, such as 68, 2, 0, 0, and 0. The detection rate of lung cancer also improved. It is possible for PCMCSS to annually conduct surveys to determine whether the local government has appropriate information to evaluate the quality of lung cancer screening systems. Such surveys improve the distribution of response to better direction.