In Japan, there are near 600.000 incidences and 300.000 mortalities of cancer. This mortality rate of cancer is most high in Japan.
Lung cancer, pancreatic duct cancer, esophagus cancer are grouped in poor prognosis. Pancreas is located in retroperitoneal space. Therefore, no symptom appears even in case of small size of pancreatic duct cancer. In fact, the data of summarized small pancreatic cancers demonstrated 57% of 5 year survival even in less tumor size than 1 cm. Therefore, it is necessary to detect much smaller pancreatic cancer. In Osaka Medical Center for Cancer and Cardiovascular Diseases, we have succeeded in establishing high risk group of pancreatic cancer, accompanied with pancreatic duct dilatation and/or pancreatic cyst. There was 9 fold detection of pancreatic cancer in established high risk group. Cytologic examination of pancreatic juice shows a higher positive rate in small size of pancreatic cancer (early stage) . In fact, all patients (only positive cytology) have survived longer than 5 years preserving good QOL.
Survival of esophagus cancer patients is also pretty poor in case of invasing into submucosal space. Endoscopic examination should be performed if we wish get a long survival and good QOL. Endoscopic examination distinguish the difference between cancer and dysplasia. Therefore, it is expected to detect the esophagus cancer of extremely early stage and to resect by the method of EMR and ESD.
It is eagerly expected to develop the effective medical examination against cancer and to detect the extremely small cancer in near future.