Annual Report 2020
Division of Screening Assessment and Management
Tomio Nakayama, Hirokazu Takahashi, Satoyo Hosono, Akiko Matsumoto, Kanako Kono, Noriaki Takahashi, Haruo Fujitani, Kanoko Matsushima, Akiko Totake, Nao Ida, 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 the activities they are in charge of. One is the activity for assessing cancer screening, and the other for Quality Assurance. S. Hosono is the head of the former team, and K. Kono, N. Takahashi and H. Fujitani manage the prospective studies for evaluation of cancer screening and A. Totake, N. Ida and R. Haruta assist the studies. T. Nakayama and K. Matsushima manage the development of cancer screening guidelines. H. Takahashi is involved in the latter team.
Research activities
1) The studies to evaluate the effectiveness of cancer screening
The randomized controlled trial (Akita study) to evaluate screening for colon cancer using total colonoscopy has completed recruitment. A follow-up study is ongoing using demographic survey and regional cancer registry, and a design paper has been published (Int J Colorectal Dis 2020). 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 4th round screening for participants registered in 2014, and the baseline data has been published (J gynecol oncol 2021). As a follow-up team of an ongoing randomized controlled trial (JEC study) of lung cancer screening using low-dose CT, we collected diagnostic data and conducted a follow-up study using mail-based and telephone-based questionnaire.
2) Development of cancer screening guidelines and related issues
The new guidelines of cervical cancer screening have been released. We started developing the evidence report of colon cancer screening; evaluation of benchmark of stool test has been completed, and evaluation of colonoscopy has been started.
3) Dissemination and implementation of cancer screening
To disseminate and implement cervical cancer screening using HPV test recommended by the new screening guidelines, we started to develop a diagnostic algorithm and a process indicator for quality control. In addition, we started an intervention study at workplaces with the endpoint of whether the self-collected HPV test, which was expected as a measure to prevent unscreened cases, would lead to gynecological consultation.
4) Quality assurance of cancer screening
The analysis of the checklist survey in population-based screening revealed that the development of the system for clinic-based screening was significantly delayed and that feedback on project evaluation has not been provided. An updated version of the "Report on the Project Evaluation of Cancer Screening" compiled by the MHLW's committee on Cancer Screening was prepared and released.
A checklist survey, which is part of the "Manual for Cancer Screening in the Workplace," was conducted, but few insurers were able to answer all the questions, therefore it was judged that the checklist needed to be revised. To resolve this issue, the following measures are identified: unification of the data format for cancer screening, improvement of the literacy of personnel in charge, and establishment of a system to grasp the screening outcomes.
Future Prospects
For the efficacy evaluation study, we will continue our follow-up studies. As for the screening guidelines, we will update the guidelines for colorectal cancer screening and lung cancer screening.
For quality assurance of cancer screening, we will release a revised proposal for process indicators for population-based screening and study a revised checklist for occupational screening. A survey on the impact of the new coronavirus infection on cancer screening will be conducted.
List of papers published in 2020
Journal
1. Kono K, Morisada T, Saika K, Aoki ES, Miyagi E, Ito K, Takahashi H, Nakayama T, Saito H, Aoki D. The first-round results of a population-based cohort study of HPV testing in Japanese cervical cancer screening: baseline characteristics, screening results, and referral rate. J Gynecol Oncol, 32:e29, 2021
2. Taniguchi M, Ueda Y, Yagi A, Miyoshi A, Tanaka Y, Minekawa R, Endo M, Tomimatsu T, Hirai K, Nakayama T, Kimura T. Disparity of Cervical Cancer Risk in Young Japanese Women: Bipolarized Status of HPV Vaccination and Cancer Screening. Vaccines (Basel), 9:2021
3. Saito H, Kudo SE, Takahashi N, Yamamoto S, Kodama K, Nagata K, Mizota Y, Ishida F, Ohashi Y. Efficacy of screening using annual fecal immunochemical test alone versus combined with one-time colonoscopy in reducing colorectal cancer mortality: the Akita Japan population-based colonoscopy screening trial (Akita pop-colon trial). Int J Colorectal Dis, 35:933-939, 2020
4. Aoe J, Ito Y, Fukui K, Nakayama M, Morishima T, Miyashiro I, Sobue T, Nakayama T. Long-term trends in sex difference in bladder cancer survival 1975-2009: A population-based study in Osaka, Japan. Cancer Med, 9:7330-7340, 2020
5. Yagi A, Ueda Y, Masuda T, Ikeda S, Miyatake T, Nakagawa S, Hirai K, Nakayama T, Miyagi E, Enomoto T, Kimura T. Japanese Mothers' Intention to HPV Vaccinate Their Daughters: How Has It Changed over Time Because of the Prolonged Suspension of the Governmental Recommendation? Vaccines (Basel), 8:2020
6. Nakagiri T, Nakayama T, Tokunaga T, Takenaka A, Kunoh H, Ishida H, Tomita Y, Nakatsuka SI, Nakamura H, Okami J, Higashiyama M. Novel Imprint Cytological Classification for Small Pulmonary Adenocarcinoma Using Surgical Specimens: Comparison with the 8th Lung Cancer Staging System and Histopathological Classification. J Cancer, 11:2845-2851, 2020
7. Nakagiri T, Nakayama T, Tokunaga T, Takenaka A, Kunoh H, Ishida H, Tomita Y, Nakatsuka SI, Nakamura H, Okami J, Higashiyama M. Intraoperative Diagnosis and Surgical Procedure with Imprint Cytology for Small Pulmonary Adenocarcinoma. J Cancer, 11:2724-2729, 2020
8. Masaoka H, Matsuo K, Oze I, Ito H, Naito M, Wada K, Nagata C, Nakayama T, Kitamura Y, Sadakane A, Tamakoshi A, Tsuji I, Sugawara Y, Sawada N, Mizoue T, Inoue M, Tanaka K, Tsugane S, Shimazu T. Alcohol Drinking and Bladder Cancer Risk From a Pooled Analysis of Ten Cohort Studies in Japan. J Epidemiol, 30:309-313, 2020