Annual Report 2023
Division of Screening Assessment and Management
Tomio Nakayama, Hirokazu Takahashi, Satoyo Hosono, Ryoko Machii, Noriaki Takahashi, Jin Miyazawa, Motoi Miura, Takeshi Enomoto, Toshifumi Nanba, Kazuko Matsuda, Sayo Aikawa, Nao Ida, Eri Yano, Masayo Ishii, Tokiyo Fukui, Mayuko Tsukakoshi, Yuuko Nakano
Introduction
Our division conducts research on cancer screening assessment (large scale efficacy study and guideline development) and cancer screening management (quality control), as well as training and research projects related to cancer screening, to promote evidence-based cancer screening in Japan.
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 N. Takahashi and J. Miyazawa manage the prospective studies for evaluation of cancer screening and S. Aikawa assists in the studies. S. Hosono manages the development of cancer screening guidelines and E. Yano, Y. Nakano and N. Ida assist with the work. H. Takahashi is involved in the latter team (quality assurance) and R. Machii, K. Matsuda, M. Tsukakoshi, M. Ishii, T. Fukui and M. Tsukakoshi assist with the work.
Research Activities
Cancer Screening Assessment
1) Studies to evaluate the effectiveness of cancer screening
A randomized controlled trial to evaluate screening for colon cancer using total colonoscopy has completed recruitment. A follow-up study is ongoing using the vital statistics and other data, and sub-study about the sensitivity of total colonoscopy has started.
As for a cohort study to evaluate screening for cervical cancer using HPV test and Pap smear, we prepared applications for the National Cancer Registry.
As a follow-up team of an ongoing randomized controlled trial of lung cancer screening using low-dose CT, we provided residential referrals for 318 cases registered until FY2018 that could not be contacted, and confirmed the cause and date of death for those who died, using the vital statistics. Furthermore, preparation for application to the National Cancer Registry was initiated.
2) Development of cancer screening guidelines and related issues
A colorectal cancer screening guideline draft was revised in response to external comments. For lung cancer screening, plain chest X-ray, sputum cytology, and low-dose CT were examined, and guideline draft was completed. Evidence of thyroid cancer screening was reviewed.
Cancer Screening Management
1) Development of information tool for workplace screening
Based on the fact that workplace screening lacks the correct knowledge of cancer screening due to the lack of involvement of medical personnel and the lack of government-recommended cancer screening, we created an educational video for those in charge of screening in the workplace and made it available to the public on the Cancer Information Service.
2) Impact of COVID-19 infection on cancer screening and care
Evaluation of the impact of COVID-19 on cancer screening and care was examined based on the national hospital cancer registry counts, which showed that the significant decline in registrations in 2020 was recovered in 2021, but remained flat in 2022, halting the previous upward trend.
3) Creation of a reliable cancer screening uptake rate measurement method
The national cancer screening uptake rate is estimated by the National Cancer Surveys. To verify the validity of this estimate, a research plan is currently being formulated to match the screening uptake rate with the individual's report and the screening records. We also summarized the estimation methods of the screening uptake rates in high income countries and the differences among the different estimation methods.
4) Cancer screening for persons with disabilities
In line with the slogan of the Fourth Basic Plan for the Promotion of Cancer Control, “No one is left behind”, interviews were conducted with local governments, facilities for persons with disabilities, and medical personnel regarding the actual status of cancer screening for persons with disabilities, and it was revealed that some persons with disabilities refrain from receiving cancer screening depending on the degree of their disability and medical personnel felt ethical dilemma about this.
Future Prospects
In the large-scale efficacy evaluation studies, we will continue to conduct follow-up studies and publish the results of studies other than the primary endpoints as they become available. For guidelines, we plan to release the results of colorectal cancer and lung cancer in FY2024. Regarding the validity study of the National Surveys on Lifestyle, we plan to conduct a survey study in Miyagi Prefecture after approval by the Ethics Review Committee. In addition, a study using receipts will be conducted to estimate the number of screening-like activities using health insurance. Regarding research on cancer screening for persons with disabilities, we plan to examine overseas cases and measure the screening uptake rate of local government screening for persons with disabilities.
List of papers published in 2023
Journal
1. Yagi A, Nakagawa S, Ueda Y, Oka E, Ikeda S, Kakuda M, Kobayashi E, Ito Y, Katayama K, Hirai K, Nakayama T, Kimura T. Effectiveness of catch-up and routine program of the 9-valent vaccine on cervical cancer risk reduction in Japan. Cancer science, 115:916-925, 2024
2. Machii R, Takahashi H, Miyazawa J, Nakayama T. Cancer screening in Japan 2 years after the COVID-19 pandemic: Changes in participation, 2017-2021. Preventive medicine reports, 39:102649, 2024
3. Sakakibara A, Nakayama T, Uchida H, Odagiri Y, Ito Y, Katayama T, Ueda Y, Higuchi T, Terakawa K, Matsui K, Miyazaki K, Konishi I. Trends and future projections of cervical cancer-related outcomes in Japan: What happens if the HPV vaccine program is not implemented? International journal of cancer, 152:1863-1874, 2023
4. Lam DC, Liam CK, Andarini S, Park S, Tan DSW, Singh N, Jang SH, Vardhanabhuti V, Ramos AB, Nakayama T, Nhung NV, Ashizawa K, Chang YC, Tscheikuna J, Van CC, Chan WY, Lai YH, Yang PC. Lung Cancer Screening in Asia: An Expert Consensus Report. Journal of thoracic oncology, 18:1303-1322, 2023
5. Nakagawa S, Yagi A, Ueda Y, Ikeda S, Kakuda M, Hiramatsu K, Miyoshi A, Kimura T, Hirai K, Sekine M, Nakayama T, Kobayashi E, Miyagi E, Enomoto T, Kimura T. Intentions for catch-up HPV vaccination in Japan: an internet survey. International journal of clinical oncology, 28:1667-1679, 2023
Book
1. Aoki D (ed), Recent Topics on Prevention, Diagnosis, and Clinical Management of Cervical Cancer, Springer, Singapore, 2024