Annual Report 2018
Division of Screening Assessment and Management
Tomio Nakayama, Koichi Nagata, Hirokazu Takahashi, Kanako Kono, Noriaki Takahashi, Sayuri Amanuma, Kanoko Matsushima, Akiko Totake, Asako Kowada, Nao Ida, Masami Kimura, Rie Haruta
Introduction
The Division of Screening Assessment and Management has conducted studies on the assessment and management of screening programs, particularly those of 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 established quality assurance systems for the screening programs (Cancer Screening Management).
The Team and What We Do
Our division consists of two teams according to their activities in charge. One is the activity for assessing cancer screening, and the other for Quality Assurance. T. Nakayama is the head of the former team, and K. Nagata, K. Kono, and N. Takahashi manage the prospective studies for evaluation of cancer screening and A. Totake, A. Kowada, N. Ida and R. Haruta assist the studies. T Nakayama and K. Matsushima managed the development of cancer screening guidelines while H. Takahashi and M. Kimura are involved in the latter team.
Research activities
1. Cancer Screening Assessment
1) Studies to evaluate effectiveness of cancer screening
The randomized controlled trial (Akita study) to evaluate screening for colon cancer using total colonography finished recruiting volunteers at the end of March 2017 (a total of 9,751 persons). A follow-up study is ongoing using a demographic survey and regional cancer registry. A cohort study to evaluate screening for cervical cancer using an HPV test and Pap smear has passed the midpoint of the total study period to perform third round screening for participants registered in 2013.
We established a follow-up team for an ongoing randomized controlled trial (JEC study) of lung cancer screening using low-dose CT, and started organizing data on up to 10,000 persons and detailed examination results and prognostic information.
2) Development of cancer screening guidelines and related issues
The evidenced report of cervical cancer screening has been ongoing and the meta-analysis revealed three points.
i. Weak evidence that cervical cancer screening using HPV test is more effective in reducing the incidence of invasive cancer than a conventional cytology test.
ii. Screening using the HPV test significantly increases the number of false positives as a disadvantage compared to the conventional cytology test, especially 101 false positive cases in combined tests per 1,000 tests.
iii. The HPV self-collection method is about 10% lower than the doctor-collection method in terms of sensitivity, and the specificity remains almost unchanged, indicating that it can be used in areas where gynecologists are scarce.
3) Quality assurance of cancer screening
In occupational screening, we worked to identify cancer patients using the medical prescription and to understand the actual management system of cancer screening. In the latter case, it became clear that there are very diverse management systems and a lack of understanding by corporate managers.
In population-based screening, we worked on analysis of quality control data and extraction of problems.
Education
Training lecture for leaders for cancer screening in prefectures (18-May-2018)
Workshop for new staff for cancer screening in prefectures (19-May-2018)
Future prospects
In screening assessment studies, progress management will continue until the follow-up is completed with the goal of completing largescale prospective studies. the colorectal cancer screening guidelines will be updated from 2019. In quality control, we will propose quality control methods in the workplace.
List of papers published in 2018
Journal
1. Nawa T, Fukui K, Nakayama T, Sagawa M, Nakagawa T, Ichimura H, Mizoue T. A population-based cohort study to evaluate the effectiveness of lung cancer screening using low-dose CT in Hitachi city, Japan. Jpn J Clin Oncol, 49:130-136, 2019
2. Yagi A, Ueda Y, Kakuda M, Tanaka Y, Ikeda S, Matsuzaki S, Kobayashi E, Morishima T, Miyashiro I, Fukui K, Ito Y, Nakayama T, Kimura T. Epidemiological and clinical analyses of cervical cancer using data from the population-based Osaka cancer registry. Cancer Res, 2019
3. Fukui K, Ito Y, Nakayama T. Trends and projections of cancer mortality in Osaka, Japan from 1977 to 2032. Jpn J Clin Oncol, 49:383-388, 2019
4. Utano K, Takayanagi D, Nagata K, Aizawa M, Endo S, Nemoto T, Nemoto D, Isohata N, Lefor AK, Togashi K. A novel volume-reduced CT colonography regimen using hypertonic laxative (polyethylene glycol with ascorbic acid): randomized controlled trial. Eur Radiol, 2019
5. Sagawa M, Machii R, Nakayama T, Sugawara T, Ishibashi N, Mitomo H, Kondo T, Tabata T. The Prefectural Participation Rates of Lung Cancer Screening Had a Negative Correlation with the Lung Cancer Mortality Rates. Asian Pac J Cancer Prev, 20:855- 861, 2019
6. Takahashi N, Nagata K, Iyama A, Mikami T, Kanazawa H, Saito H. Colonic distention and patient acceptance of CT colonography: supine/prone vs left/right lateral scanning. Br J Radiol, 20180538, 2018
7. Oze I, Ito H, Nishino Y, Hattori M, Nakayama T, Miyashiro I, Matsuo K, Ito Y. Trends in Small-Cell Lung Cancer Survival in 1993-2006 Based on Population-Based Cancer Registry Data in Japan. J Epidemiol, 2018
8. Toyoda Y, Tabuchi T, Nakata K, Morishima T, Nakayama T, Miyashiro I, Hojo S, Yoshioka S. Increase in incidental detection of thyroid cancer in Osaka, Japan. Cancer Sci, 109:2310-2314, 2018
9. Ueda Y, Yagi A, Nakayama T, Hirai K, Ikeda S, Sekine M, Miyagi E, Enomoto T. Dynamic changes in Japan's prevalence of abnormal findings in cervical cervical cytology depending on birth year. Sci Rep, 8:5612, 2018
10. Machii R, Saika K, Kasuya K, Takahashi H, Saito H. Trends in the quality assurance process indicators for Japanese colorectal cancer screening during 2003-13. Jpn J Clin Oncol, 48:329-334, 2018