Division of Screening Assessment and Management
Chisato Hamashima, Hirokazu Takahashi
Senior Staff Scientist
Sayuri Amanuma, Junko Asai, Kanoko Matsushima,Akiko Totake,Asako Kowada, Ikuko Tominaga
The Division has conducted studies onthe assessment and management of screeningprograms, particularly nationwide programs, andon other issues relevant to cancer screening.
In addition, the most important mission ofthe Research Center for Cancer Prevention andScreening in terms of screening is the centralactivity of assessing and managing cancer screeningat the national level, which is closely related tothe pillars in the Individual Targets for CancerScreening in the Basic Cancer Control Plan issuedin 2007 and revised in 2012. Thus, the Divisionhas developed and updated screening guidelines(Cancer Screening Assessment) and constructedquality assurance systems for the screeningprograms (Cancer Screening Management).
Development of cancer screening guidelines
Guidelines on screening for gastric cancerwere published in 2015. Evidence report for cervicalcancer will be published in 2016.
Revision of Cancer Screening Checklists (CLs)
The screening programs performed as theHealth Promotion Services by the Ministry ofHealth, Labour and Welfare consist of screeningprograms provided through large screeningfacilities and those via primary physicians. CLswere primarily developed targeting the formertype of programs but could not cover the latterprograms. The Division developed new structureindicators that cover all of the screening programsby revising the original CLs. The appropriatenessof the new CLs was confirmed through preliminaryuse in six areas. The new CLs were proposed asthe substitute for the present CLs for use after 2016and adoption as the new ones was decided bythe council of the Ministry of Health, Labour andWelfare.
Quality Assurance (QA) in cancer screening atmunicipalities and prefectures
The Division collected the informationrelated to implementation of cancer screeningand its management situation using the CancerScreening Checklists (CLs) as a structure indicatorin quality assurance at municipalities. TheDivision set up the website in 2013 that allowssupport for municipalities such as provision oftheir QA data archives and information relevantto cancer screening. CLs data were collected frommunicipalities and evaluation results were fed backon the website. In this year, 1,592 municipalities(91%) utilized the website by registering asmembers of the site. Analysis of the results in2015 will be available early in 2016. The Divisionevaluated QA activity in each of the 47 prefecturesand published the results. For those prefectureswhose performance level was below the definedlevel, instructions were sent to ask them to improvethe status.
The Division also investigated the methodto calculate the participation rate in screeningprograms provided at worksites as well as theconstruction of the QA system of those programs.
Workshop on cancer screening management
The Division held one-day educationalworkshops for the members of prefecturalcommittees for cancer screening management,aiming at activating quality assurance activitiesin each of the 47 prefectures. The themes this yearwere the breast and cervix. The main contents of theworkshops were the methods of quality assuranceof the screening programs within each prefecture.Other basic issues required to conduct organizedcancer screening programs such as those issuesfor screening assessment were also included in thecontents. The Division also held a similar workshoptargeting the new members of the cancer controlsection at each prefectural government.
There were 63 participants in the workshopsfrom 34 prefectures, who consisted of administrativeofficers (51%) and members of the committee (49%).This activity was performed as a project for theCenter for Cancer Control and Information Servicesand will be continued on an annual basis.
According to the survey on the activity of theprefectural committees, 37 to 39 prefectures heldmeetings to discuss cancer screening managementand 20 to 22 (15 to 18 in the previous year) releasedthe evaluation results of municipalities using CLsfor each of the 5 cancers. These figures have beenincreasing after starting the workshop, suggestingthere was an effect of the previously held workshopon the activity of the committees.
A randomized controlled trial (RCT) ofcolonoscopic screening and other RCTs
A randomized controlled trial evaluatingone-time colonoscopic screening for colorectalcancer was started in 2009. The division has beenresponsible for designing and managing the studyas the head office of the study. The cumulativenumber of subjects who gave informed consent,and who were thus enrolled in the study, was 8,576at December 2015, corresponding to 86% of theplanned number. Data monitoring results showedrandomization has been performed successfully. Noserious adverse effect was reported on screeningcolonoscopy. The Division has also participatedin other RCTs (breast cancer and lung cancerscreening) as a member of the headquarters of theresearch and supported those studies.
A cohort study to evaluate the efficacy of cervicalcancer screening using human papilloma virusin conjunction with pap smear cytology.
The Division has supported the managementof the study as the head office. A total of 20,459subjects have participated in the study as of the endof 2015 in 36 municipalities.
Evaluation and accuracy studies on gastric cancerscreening
A community-based, cohort study wasconducted to evaluate the effectiveness ofendoscopic screening in Niigata city. The 57%mortality reduction from gastric cancer wassuggested by endoscopic screening for gastricca
List of papers published in 2015
- Tanaka S, Saitoh Y, Matsuda T, Igarashi M, Matsumoto T, IwaoY, Suzuki Y, Nishida H, Watanabe T, Sugai T, Sugihara K,Tsuruta O, Hirata I, Hiwatashi N, Saito H, Watanabe M, SuganoK, Shimosegawa T, Japanese Society of Gastroenterology.Evidence-based clinical practice guidelines for management ofcolorectal polyps. J Gastroenterol, 50:252-260, 2015 [PubMed]
- Taniguchia T, Hiraib K, Haradac K, Ishikawad Y, NagatsukaeM, Fukuyoshif J, Araig H, Mizotah Y, Yamamotoi S, Saitoj H,Shibuyak D. The relationship between obtaining fecal occultblood test and beliefs regarding testing among Japanese.Health Psychol Behav Med, 3:251-262, 2015
- Goto R, Hamashima C, Mun S, Lee WC. Why screening ratesvary between Korea and Japan--differences between two nationalhealthcare systems. Asian Pac J Cancer Prev, 16:395-400, 2015 [PubMed]
- Hamashima C, Ogoshi K, Narisawa R, Kishi T, Kato T, FujitaK, Sano M, Tsukioka S. Impact of endoscopic screening onmortality reduction from gastric cancer. World J Gastroenterol,21:2460-2466, 2015 [PubMed]
- Hamashima C, Shabana M, Okamoto M, Osaki Y, KishimotoT. Survival analysis of patients with interval cancer undergoinggastric cancer screening by endoscopy. PLoS One,10:e0126796, 2015 [PubMed]
- Hamashima C, Ohta K, Kasahara Y, Katayama T, Nakayama T,Honjo S, Ohnuki K. A meta-analysis of mammographic screeningwith and without clinical breast examination. Cancer Sci,106:812-818, 2015 [PubMed]
- Hamashima C, Shabana M, Okada K, Okamoto M, Osaki Y.Mortality reduction from gastric cancer by endoscopic and radiographicscreening. Cancer Sci, 106:1744-1749, 2015 [PubMed]
- Lauby-Secretan B, Scoccianti C, Loomis D, Benbrahim-TallaaL, Bouvard V, Bianchini F, Straif K, International Agency forResearch on Cancer Handbook Working Group. Breast-cancerscreening--viewpoint of the IARC Working Group. N Engl JMed, 372:2353-2358, 2015 [PubMed]
- Hamashima C. Have we Comprehensively Evaluated theEffectiveness of Endoscopic Screening for Gastric Cancer?Asian Pac J Cancer Prev, 16:3591-3592, 2015 [PubMed]
- Saika K, Machii R. Five-year relative survival rate of brain andother nervous system cancer in the USA, Europe and Japan.Jpn J Clin Oncol, 45:313-314, 2015 [PubMed]
- Machii R, Saika K. Morphological distribution of esophagealcancer from Cancer Incidence in Five Continents Vol. X. Jpn JClin Oncol, 45:506-507, 2015 [PubMed]
- Saika K, Matsuda T. Morphological distribution of ovarian cancerfrom Cancer Incidence in Five Continents Vol. X. Jpn J ClinOncol, 45:793, 2015 [PubMed]
- Matsuda T, Machii R. Morphological distribution of lung cancerfrom Cancer Incidence in Five Continents Vol. X. Jpn J ClinOncol, 45:404, 2015 [PubMed]
- Nagata K, Fujiwara M, Shimamoto T, Iida N, Mogi T, MitsushimaT. Colonic distention at CT colonography: randomized evaluationof both IV hyoscine butylbromide and automated carbondioxide insufflation. AJR Am J Roentgenol, 204:76-82, 2015 [PubMed]
- Nagata K, Fujiwara M, Kanazawa H, Mogi T, Iida N, MitsushimaT, Lefor AT, Sugimoto H. Evaluation of dose reduction andimage quality in CT colonography: comparison of low-dose CTwith iterative reconstruction and routine-dose CT with filteredback projection. Eur Radiol, 25:221-229, 2015 [PubMed]