[Decline of autopsy rates in Japan and the significance of autopsy in gastric carcinoma].

In recent years, the significance of autopsy seems to have gradually declined, because of advances in diagnostic technology. However, rediscovery of the value of autopsy has been recently emphasized by many foreign authors, and in some reports concerning diagnostic accuracy, no significant difference was observed between the three decades of the Sixties, Seventies and Eighties. Comparing the autopsy rates in 1977 and 1986 in Japan, one notes a decrease from 37.8% to 28.5%. And this declining tendency will continue for the foreseeable future. In order to confirm the value of autopsy, 100 sequential autopsy cases of gastric carcinoma in Kanto Teishin Hospital were reviewed. The autopsy rate of gastric carcinoma was 66.1% over the past decade. In 38 autopsy cases, some notable findings were provided by postmortem examination, and they may be summarized as follows. Clinically incorrect diagnosis for primary organ in 2 cases; unexpected spread of carcinoma in 2; improper cancer therapy in 8; favourable effects of anticancer drug in 4; underestimation of clinical observation in 11; latent tumors in 7; confirmation of other pathological findings than cancer in 4. The results suggest that autopsy plays an important part in the progress of medical care. In order to stop this declining trend, the department of pathology must be legally recognized as an essential unit in a hospital. Thus the autopsies should be performed not only with a view to research, but as one of the routine tasks in medical care. And cooperative efforts by both clinicians and pathologists are necessary to maintain the autopsy rates.