Annual Report 2017
Division of Screening Assessment and Management
Hiroshi Saito, Chisato Hamashima, Koichi Nagata, Hirokazu Takahashi, Kumiko Saika, Kanako Kono, Ayako Aoki, Yoshiki Ishikawa, Sayuri Amanuma, Junko Asai, Kanoko Matushima, Akiko Totake, Asako Kowada, Ikuko Tominaga, Yu Kawabe
Introduction
The Division of Screening Assessment and Management has conducted studies on the assessment and management of screening programs, particularly nationwide programs, and on other issues relevant to cancer screening. In addition, the most important mission of the Center for Public Health Sciences in terms of screening, is the central activity of assessing and managing cancer screening at the national level, which is closely related to the pillars in the Individual Targets for Cancer Screening in the Basic Cancer Control Plan. Thus, our division has developed and updated screening guidelines (Cancer Screening Assessment), and constructed quality assurance systems for the screening programs (Cancer Screening Management).
Our team and what we do
Our division consists of two teams according to their responsible activities. One is the activity for developing cancer screening guidelines, and the other for Quality Assurance. H. Saito is involved in both activities. C. Hamashima is the head of the former team, and J. Asai, K. Matsushima, and I. Tominaga also belong to the team. The rest of the members are those of a latter team. In addition, H. Saito, C. Hamashima, K. Saika, K. Kono, and K. Nagata are also involved with the research activity.
Research activities
1. Cancer Screening Assessment
1) The studies to evaluate the effectiveness of cancer screening
A randomized controlled trial (Akita study) to evaluate screening for colon cancer using total colonography completed recruitment at the end of March 2017 (a total of 9,751 persons). Then, follow up study is ongoing using demographic survey and regional cancer registry. A cohort study to evaluate screening for cervical cancer using HPV test and Pap smear has passed the midpoint of the total study period to perform the third round screening for participants registered in 2013. A randomized controlled trial to evaluate screening for gastric cancer using gastroscopy versus Helicobacter pylori antibody and pepsinogen test has progress in recruitment of participants.
2) Development of cancer screening guidelines and related issues During the development of the evidenced report of cervical cancer screening, the meta-analysis revealed that the frequency of unsatisfactory cervical smear was decreasing in recent years (Cancer Sci 2018).
We clarified that the number of regional medical clinic correlates with the screening rate of cervical and breast screening (PLoS One 2017).
We conducted a nationwide survey of accident with CT colonography which was able to be further examination of CRC screening (Eur Radiol 2017).
3) Quality assurance of cancer screening
We have surveyed the cancer screening checklist as a structure indicator in quality assurance in municipalities. Clinic-based screening was included in the survey from this year and the achievement rate of all items was clarified that a clinic-based screening is significantly lower than mass screening.
We conducted an interview survey for 20 municipalities with excellent QA and summarized successful cases as Quality Assessment Manual for municipality staff Ver. 2.
Education
- A training lecture for leaders for cancer screening in prefectures
- A workshop for new stuff for cancer screening in prefectures
Future prospects
We will continue to manage progress and aim for completion of high-quality large-scale studies in the effectiveness of cancer screening and aim to complete the guideline of cervical cancer screening in 2018. We will develop a quality control method of cancer screening at workplace.
List of papers published in January 2017 - March 2018
Journal
1. Hamashima C, Narisawa R, Ogoshi K, Kato T, Fujita K. Optimal interval of endoscopic screening based on stage distributions of detected gastric cancers. BMC Cancer, 17:740, 2017
2. Nagata K, Takabayashi K, Yasuda T, Hirayama M, Endo S, Nozaki R, Shimada T, Kanazawa H, Fujiwara M, Shimizu N, Iwatsuki T, Iwano T, Saito H. Adverse events during CT colonography for screening, diagnosis and preoperative staging of colorectal cancer: a Japanese national survey. Eur Radiol, 27:4970-4978, 2017
3. Sano H, Goto R, Hamashima C. Does lack of resources impair access to breast and cervical cancer screening in Japan? PLoS One, 12:e0180819, 2017
4. Hamashima C, Goto R. Potential capacity of endoscopic screening for gastric cancer in Japan. Cancer Sci, 108:101-107, 2017
5. Chen TH-H, Yen AM-F, Fann JC-Y, Gordon P, Chen SL-S, Chiu SY-H, Hsu C-Y, Chang K-J, Lee W-C, Yeoh KG, Saito H, Promthet S, Hamashima C, Maidin A, Robinson F, Zhao L-Z. Clarifying the debate on population-based screening for breast cancer with mammography: A systematic review of randomized controlled trials on mammography with Bayesian meta-analysis and causal model. Medicine (Baltimore), 96:e5684, 2017
6. Hamashima C. Overdiagnosis of gastric cancer by endoscopic screening. World J Gastrointest Endosc, 9:55-60, 2017
7. Utano K, Nagata K, Honda T, Mitsushima T, Yasuda T, Kato T, Horita S, Asano M, Oda N, Majima K, Kawamura Y, Hirayama M, Watanabe N, Kanazawa H, Lefor AK, Sugimoto H. Diagnostic Performance and Patient Acceptance of Reduced-Laxative CT Colonography for the Detection of Polypoid and Non-Polypoid Neoplasms: A Multicenter Prospective Trial. Radiology, 282:399-407, 2017
8. Nagata K, Endo S, Honda T, Yasuda T, Hirayama M, Takahashi S, Kato T, Horita S, Furuya K, Kasai K, Matsumoto H, Kimura Y, Utano K, Sugimoto H, Kato H, Yamada R, Yamamichi J, Shimamoto T, Ryu Y, Matsui O, Kondo H, Doi A, Abe T, Yamano H-O, Takeuchi K, Hanai H, Saida Y, Fukuda K, Nappi J, Yoshida H. Accuracy of CT Colonography for Detection of Polypoid and Nonpolypoid Neoplasia by Gastroenterologists and Radiologists: A Nationwide Multicenter Study in Japan. Am J Gastroenterol, 112:163-171, 2017
9. Matsuoka M, Shimizu N, Nagata K, Saito H. Colon cancer with rapid growth in 16months confirmed by computed tomographic colonography. Arab J Gastroenterol, 19:45-46, 2018
10. Hamashima C. Cancer screening guidelines and policy making: 15 years of experience in cancer screening guideline development in Japan. Jpn J Clin Oncol, 48:278-286, 2018
11. Hosono S, Terasawa T, Katayama T, Sasaki S, Hoshi K, Hamashima C. Frequency of unsatisfactory cervical cytology smears in cancer screening of Japanese women: A systematic review and meta-analysis. Cancer Sci, 109:934-943, 2018