A total of 146 patients with breast cancer were operated on at our hospital between April 1991 and January 1997. The number of those patients who had undergone mass screening was 37. Those 37 patients were divided into three groups: 18 patients with interval breast cancer (the interval group), 12 patients having breast cancer detected by mass screeing (the mass screening group) and 7 patients diagnosed with breast cancer in outpatients clinics during the course of periodic routine examinations (the outpatient clinic group). To investingate the limitations and beneficial effects of mass screening programs consisting of observation and palpation, seven clinicopathological factors were analyzed, with special attention paid to tumor doubling times. These factors were % body fat, tumor size at the time of mass screening calculated from the age-dependent tumor doubling times, interval between mass screening and surgery, actual tumor size at the time of surgery, histological type, extent of nodal involvement and pathological staging. The percentage of early breast cancer was higher for these groups than for the other 109 patients, who had never undergone mass screening (59.4% versus 32.1%, p<0.01). However, the following limitations were found. In mass screening, it was difficult to detect masses smaller than 2 cm in diameter. Analysis of th data for the interval group showed that it was possible for women to find a breast mass measuring around 2cm through self-examination and that mass screening had no difinite advantage over the self-examination. In addition, it was found that earlier detection was called for in outpatient clinics in terms of the nodal status. We concluded that the benefits of the currently organized mass screening programs were doubtful. Women should be educated about the importance of self-examining their breasts and taught how to practice the self-examination. Goals should include finding women who considered at high risk and detecting breast cancer 1 cm or smaller in diameter during the course of periodic examinations at medical institutions.

Personal lifestyles constitute one of the strategic frontiers of preventive medicine. We carried out a survey of eating habits of people in three rural communities in the southern part of Akita Prefecture, where fundamental health screening programs have been implemented regularly. Differences in eating habits between men and women and between age groups were found. The health status of the examinees was judged by using data on blood pressure, obesity and lipid levels measured at the latest health checkup.
To find a correlation between eating habits and physical health status, the frequency of illness was examined according to the number of times of eating various kinds of food. It was found that with age, people take in fish and shellfish, cow's milk, beans, vegetables, Japanese confections and soup more frequently and eat less meat. The incidence of hypertension varied by age and sex, but was higher in those who eat less soup, pickles and milk. Likewise, abnormally high levels of total serum cholesterol were found in women who eat meat, eggs and greasy food less than twice a week. It was thought that those hypertensives and those with high cholesterol values are cuttingdown on their intake of those foods of their own accord. Therefore, we would like to point out that, in the secondary prevention setting, physicians and other health care providers should know in advance whether their patients are putting themselves on a restricted diet or not.
When the average serum lipid values were examined according to the number of times of eating meat or fish and shellfish per day, it was found that men aged 70 years or above who eat those foods more than once every day have high HDL cholesterol values and that these values significantly vary depending on the kind of meat. These findings suggested that persons of advanced age who eat well and who are not particular about their food are full of vitality. This could serve as an important point in the care of the aged with serum lipid abnormalities.
A study of evacuation and its relation to vegetable intake showed that the less the frequency of bowel movements, the smaller the amount of vegetable intake. There was a significant difference in the frequency of evacuation between vegetable eaters and those who do not consume an adequate amount of fiber.