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Division of Prevention

Division of Prevention

Chief (acting)

Shoichiro Tsugane

Section Head

Taichi Shimazu, Michihiro Mutoh

Staff Scientist

Hadrien Charvat


Nagisa Mori, Yoko Yamagiwa, Thomas Svensson,Shingo Miyamoto, Masami Komiya, Yingyan Gong

Research assistant

Yasuko Iba, Michiko Okajima, Hanako Saito


The Division of Prevention focuses onprevention research to investigate and developprevention methods (lifestyle, chemoprevention,molecular marker, etc.), risk prediction, riskstratification models, and evidence-based cancerprevention guidelines.

Research activities

Evaluation of cancer prevention strategies inJapan and cancer prevention guidelines

To develop an evidence-based cancerprevention strategy in Japan, a systematic reviewof epidemiological research was conducted. Thestrength of evidence was evaluated in a mannersimilar to that used in the WHO/FAO ExpertConsultation Report, in which evidence wasclassified as 'convincing', 'probable', 'possible'and 'insufficient'. Through this method, cigarettesmoking was evaluated to have a 'convincing'effect on increasing the risk of head and neckcancer and bladder cancer. A web-based tool topredict the 10-year risk of developing cancerbased on adhesion to 5 healthy lifestyle factorswas constructed and released to the press to bemore widely used. A pooled analysis of Japanesecohort studies was conducted and we found that amoderate intake of fruit decreases the risk of lungcancer in men. The Asia Cohort Consortium (ACC)is a collaborative effort seeking to understandthe relationship between genetics, environmentalexposure, and the etiology of disease through theestablishment of a cohort of at least one millionhealthy people throughout Asian countries. TheACC Coordinating Center was established at theFred Hutchinson Cancer Research Center andmoved to the Prevention Division in 2014. The dataanalysis system on-site and via remote access isnow established and several projects are ongoing.

Development of prevention measures based oninterventional research

We started a double-blind, randomizedclinical trial of aspirin and mesalazine to see if thesedrugs suppress the occurrence of new adenomasin patients with a history of multiple colorectaladenomas. Another clinical research project aimingto develop colorectal cancer chemopreventive drugsis in progress.

Population-based Prospective Study (the JPHCstudy and the JPHC-NEXT Study) (primarilythe development of preventive measures such asrisk prediction; searching for chemopreventioncandidates)

Based on a nested case-control study of theJapan Public Health Center-based prospective(JPHC) Study, the interaction of ADH1C, ALDH2and alcohol consumption on the development ofgastric cancer was shown. We also developed a riskprediction model for gastric cancer based on clinicaland lifestyle-related characteristics in combinationwith biological variables (ABC method) thatallows the estimation of the 10-year probability ofgastric cancer occurrence. These results suggestthe importance of risk stratification as a tool ofgastric cancer prevention. In addition, we startedresearch on collecting stomach cancer tissue inorder to consider subtypes of tumors by molecularbiomarkers.


Supervised the research of one researchresident fellowship and one senior resident in ahospital.

Future prospects

We focus on research for the development ofeffective cancer prevention strategies. In additionto current established evidence, new perspectivessuch as biomarkers from blood and tumor tissueswill be incorporated. This approach may lead tomore accurate cancer prevention strategies by riskstratification.

Figure 1. Web-based tool 'Five healthy lifestyle factors and cancer risk'.
Figure 1. Web-based tool 'Five healthy lifestyle factors and cancer risk'.

List of papers published in 2015


  1. Asada K, Nakajima T, Shimazu T, Yamamichi N, Maekita T, YokoiC, Oda I, Ando T, Yoshida T, Nanjo S, Fujishiro M, GotodaT, Ichinose M, Ushijima T. Demonstration of the usefulness ofepigenetic cancer risk prediction by a multicentre prospectivecohort study. Gut, 64:388-396, 2015 [PubMed]
  2. Yoneoka D, Henmi M, Sawada N, Inoue M. Synthesis of clinicalprediction models under different sets of covariates withone individual patient data. BMC Med Res Methodol, 15:101,2015 [PubMed]
  3. Kikuchi H, Inoue S, Odagiri Y, Inoue M, Sawada N, Tsugane S,Japan Public Health Centre (JPHC) study group. Occupationalsitting time and risk of all-cause mortality among Japaneseworkers. Scand J Work Environ Health, 41:519-528, 2015 [PubMed]
  4. Hidaka A, Shimazu T, Sawada N, Yamaji T, Iwasaki M, SasazukiS, Inoue M, Tsugane S, Japan Public Health Center-based Prospective Study Group. Fish, n-3 PUFA consumption, andpancreatic cancer risk in Japanese: a large, population-based,prospective cohort study. Am J Clin Nutr, 102:1490-1497, 2015 [PubMed]
  5. Kashino I, Mizoue T, Tanaka K, Tsuji I, Tamakoshi A, MatsuoK, Wakai K, Nagata C, Inoue M, Tsugane S, Sasazuki S,Research Group for Development and Evaluation of CancerPrevention Strategies in Japan. Vegetable consumption andcolorectal cancer risk: an evaluation based on a systematic reviewand meta-analysis among the Japanese population. Jpn JClin Oncol, 45:973-979, 2015 [PubMed]
  6. Charvat H, Goto A, Goto M, Inoue M, Heianza Y, Arase Y,Sone H, Nakagami T, Song X, Qiao Q, Tuomilehto J, TsuganeS, Noda M, Inoue M. Impact of population aging on trends indiabetes prevalence: A meta-regression analysis of 160,000Japanese adults. J Diabetes Investig, 6:533-542, 2015 [PubMed]
  7. Micha R, Khatibzadeh S, Shi P, Andrews KG, Engell RE, MozaffarianD, Global Burden of Diseases Nutrition and ChronicDiseases Expert Group (NutriCoDE). Global, regional andnational consumption of major food groups in 1990 and 2010:a systematic analysis including 266 country-specific nutritionsurveys worldwide. BMJ Open, 5:e008705, 2015 [PubMed]
  8. Kawabata-Shoda E, Charvat H, Ikeda A, Inoue M, SawadaN, Iwasaki M, Sasazuki S, Shimazu T, Yamaji T, Kimura H,Masuda S, Tsugane S. Trends in cancer prognosis in a population-based cohort survey: can recent advances in cancer therapyaffect the prognosis? Cancer Epidemiol, 39:97-103, 2015 [PubMed]
  9. Fowke JH, McLerran DF, Gupta PC, He J, Shu XO, RamadasK, Tsugane S, Inoue M, Tamakoshi A, Koh WP, Nishino Y, TsujiI, Ozasa K, Yuan JM, Tanaka H, Ahn YO, Chen CJ, SugawaraY, Yoo KY, Ahsan H, Pan WH, Pednekar M, Gu D, Xiang YB,Sauvaget C, Sawada N, Wang R, Kakizaki M, Tomata Y, OhishiW, Butler LM, Oze I, Kim DH, You SL, Park SK, Parvez F,Chuang SY, Chen Y, Lee JE, Grant E, Rolland B, ThornquistM, Feng Z, Zheng W, Boffetta P, Sinha R, Kang D, PotterJD. Associations of body mass index, smoking, and alcoholconsumption with prostate cancer mortality in the Asia CohortConsortium. Am J Epidemiol, 182:381-389, 2015 [PubMed]
  10. Ueno M, Ohara S, Sawada N, Inoue M, Tsugane S, KawaguchiY. The association of active and secondhand smoking with oralhealth in adults: Japan public health center-based study. TobInduc Dis, 13:19, 2015 [PubMed]
  11. Abe SK, Inoue M, Sawada N, Iwasaki M, Shimazu T, Yamaji T,Sasazuki S, Tanaka Y, Mizokami M, Tsugane S, JPHC StudyGroup. Hepatitis B and C virus infection and risk of lymphoidmalignancies: A population-based cohort study (JPHC Study).Cancer Epidemiol, 39:562-566, 2015 [PubMed]
  12. Kiyabu GY, Inoue M, Saito E, Abe SK, Sawada N, IshiharaJ, Iwasaki M, Yamaji T, Shimazu T, Sasazuki S, Shibuya K,Tsugane S, JPHC Study Group. Fish, n - 3 polyunsaturated fattyacids and n - 6 polyunsaturated fatty acids intake and breastcancer risk: The Japan Public Health Center-based prospectivestudy. Int J Cancer, 137:2915-2926, 2015 [PubMed]
  13. Singh GM, Micha R, Khatibzadeh S, Lim S, Ezzati M, MozaffarianD, Global Burden of Diseases Nutrition and Chronic DiseasesExpert Group (NutriCoDE). Estimated Global, Regional,and National Disease Burdens Related to Sugar-SweetenedBeverage Consumption in 2010. Circulation, 132:639-666,2015 [PubMed]
  14. Wakai K, Sugawara Y, Tsuji I, Tamakoshi A, Shimazu T, MatsuoK, Nagata C, Mizoue T, Tanaka K, Inoue M, Tsugane S, SasazukiS, Research Group for the Development and Evaluationof Cancer Prevention Strategies in Japan. Risk of lung cancerand consumption of vegetables and fruit in Japanese: A pooledanalysis of cohort studies in Japan. Cancer Sci, 106:1057-1065, 2015 [PubMed]
  15. Kato M, Noda M, Mizoue T, Goto A, Takahashi Y, Matsushita Y,Nanri A, Iso H, Inoue M, Sawada N, Tsugane S, JPHC StudyGroup. Diagnosed diabetes and premature death amongmiddle-aged Japanese: results from a large-scale population-based cohort study in Japan (JPHC study). BMJ Open,5:e007736, 2015 [PubMed]
  16. Goto A, Noda M, Matsushita Y, Goto M, Kato M, Isogawa A,Takahashi Y, Kurotani K, Oba S, Nanri A, Mizoue T, YamagishiK, Yatsuya H, Saito I, Kokubo Y, Sawada N, Inoue M, Iso H,Kadowaki T, Tsugane S, JPHC Study Group. Hemoglobin a1clevels and the risk of cardiovascular disease in people withoutknown diabetes: a population-based cohort study in Japan.Medicine (Baltimore), 94:e785, 2015 [PubMed]
  17. Saito E, Inoue M, Sawada N, Shimazu T, Yamaji T, Iwasaki M,Sasazuki S, Noda M, Iso H, Tsugane S, JPHC Study Group.Association of green tea consumption with mortality due to allcauses and major causes of death in a Japanese population:the Japan Public Health Center-based Prospective Study(JPHC Study). Ann Epidemiol, 25:512-518.e3, 2015 [PubMed]
  18. Ma E, Sasazuki S, Shimazu T, Sawada N, Yamaji T, IwasakiM, Inoue M, Tsugane S. Reactive oxygen species and gastriccancer risk: a large nested case-control study in Japan. Eur JEpidemiol, 30:589-594, 2015 [PubMed]
  19. Saito E, Inoue M, Sawada N, Shimazu T, Yamaji T, Iwasaki M,Sasazuki S, Noda M, Iso H, Tsugane S. Association of coffeeintake with total and cause-specific mortality in a Japanesepopulation: the Japan Public Health Center-based ProspectiveStudy. Am J Clin Nutr, 101:1029-1037, 2015 [PubMed]
  20. Honjo K, Iso H, Nakaya T, Hanibuchi T, Ikeda A, Inoue M,Sawada N, Tsugane S, Japan Public Health Center-based ProspectiveStudy Group. Impact of neighborhood socioeconomicconditions on the risk of stroke in Japan. J Epidemiol, 25:254-260, 2015 [PubMed]
  21. Fujimoto K, Fujii G, Taguchi K, Yasuda K, Matsuo Y, HashiyamaA, Mutoh M, Tanaka H, Wada M. Involvement of trefoil factorfamily 2 in the enlargement of intestinal tumors in ApcMin/+mice. Biochem Biophys Res Commun, 463:859-863, 2015 [PubMed]
  22. Iwasaki M, Franke AA, Hamada GS, Miyajima NT, Sharma S,Ishihara J, Takachi R, Tsugane S, Le Marchand L. Comparisonof plasma levels of nutrient-related biomarkers amongJapanese populations in Tokyo, Japan, Sテ」o Paulo, Brazil, andHawaii, USA. Eur J Cancer Prev, 24:155-161, 2015 [PubMed]
  23. Fujimoto K, Fujii G, Sakurai H, Yoshitome H, Mutoh M, WadaM. Intestinal Peyer's patches prevent tumorigenesis in ApcMin/+mice. J Clin Biochem Nutr, 56:43-48, 2015 [PubMed]
  24. Budhathoki S, Iwasaki M, Yamaji T, Sasazuki S, Takachi R,Sakamoto H, Yoshida T, Tsugane S. Dietary heterocyclic amineintake, NAT2 genetic polymorphism, and colorectal adenomarisk: the colorectal adenoma study in Tokyo. Cancer EpidemiolBiomarkers Prev, 24:613-620, 2015 [PubMed]
  25. Nakamura K, Kitamura K, Takachi R, Saito T, Kobayashi R,Oshiki R, Watanabe Y, Tsugane S, Sasaki A, Yamazaki O.Impact of demographic, environmental, and lifestyle factors onvitamin D sufficiency in 9084 Japanese adults. Bone, 74:10-17, 2015 [PubMed]
  26. Michikawa T, Inoue M, Sawada N, Tanaka Y, Yamaji T, IwasakiM, Shimazu T, Sasazuki S, Mizokami M, Tsugane S, ,for the Japan Public Health Center-based Prospective StudyGroup. Plasma isoflavones and risk of primary liver cancerin Japanese women and men with hepatitis virus infection: anested case-control study. Cancer Epidemiol Biomarkers Prev,24:532-537, 2015 [PubMed]
  27. Sawada N, Iwasaki M, Yamaji T, Shimazu T, Sasazuki S, InoueM, Tsugane S, Japan Public Health Center-based ProspectiveStudy Group. Fiber intake and risk of subsequent prostate cancerin Japanese men. Am J Clin Nutr, 101:118-125, 2015 [PubMed]
  28. Hidaka A, Sasazuki S, Matsuo K, Ito H, Sawada N, Shimazu T,Yamaji T, Iwasaki M, Inoue M, Tsugane S, JPHC Study Group.Genetic polymorphisms of ADH1B, ADH1C and ALDH2, alcoholconsumption, and the risk of gastric cancer: the JapanPublic Health Center-based prospective study. Carcinogenesis,36:223-231, 2015 [PubMed]
  29. Svensson T, Inoue M, Sawada N, Iwasaki M, Sasazuki S, ShimazuT, Yamaji T, Ikeda A, Kawamura N, Mimura M, Tsugane S,Japan Public Health Centre-based prospective Study Group.The association between complete and partial non-responseto psychosocial questions and suicide: the JPHC Study. Eur JPublic Health, 25:424-430, 2015 [PubMed]
  30. Budhathoki S, Iwasaki M, Yamaji T, Sasazuki S, Tsugane S.Coffee intake and the risk of colorectal adenoma: The colorectaladenoma study in Tokyo. Int J Cancer, 137:463-470, 2015 [PubMed]
  31. Hanibuchi T, Nakaya T, Honjo K, Ikeda A, Iso H, Inoue M,Sawada N, Tsugane S, Japan Public Health Center-basedProspective Study Group. Neighborhood contextual factors forsmoking among middle-aged Japanese: a multilevel analysis.Health Place, 31:17-23, 2015 [PubMed]
  32. Budhathoki S, Iwasaki M, Sawada N, Yamaji T, Shimazu T,Sasazuki S, Inoue M, Tsugane S, JPHC Study Group. Soyfood and isoflavone intake and endometrial cancer risk: theJapan Public Health Center-based prospective study. BJOG,122:304-311, 2015 [PubMed]
  33. Mutoh M, Ishikawa H. Metformin Use and Lung Cancer Risk-Letter. Cancer Prev Res (Phila), 8:760, 2015 [PubMed]
  34. 34. Shiotani A, Ishikawa H, Mutoh M, Takeshita T, Nakamura T,Morimoto K, Sakai T, Wakabayashi K, Sakai T, Matuura N.Genetic polymorphisms in ADH1B and ALDH2 are associatedwith colorectal tumors in Japan: a case-control study. J CancerTher, 6:1054-1062, 2015
  35. Hidaka A, Sasazuki S, Goto A, Sawada N, Shimazu T, Yamaji T,Iwasaki M, Inoue M, Noda M, Tajiri H, Tsugane S, JPHC StudyGroup. Plasma insulin, C-peptide and blood glucose and therisk of gastric cancer: the Japan Public Health Center-basedprospective study. Int J Cancer, 136:1402-1410, 2015 [PubMed]
  36. Shimazu T, Asada K, Charvat H, Kusano C, Otake Y, KakugawaY, Watanabe H, Gotoda T, Ushijima T, Tsugane S. Associationof gastric cancer risk factors with DNA methylation levelsin gastric mucosa of healthy Japanese: a cross-sectional study.Carcinogenesis, 36:1291-1298, 2015 [PubMed]


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