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Division of Screening Assessment and Management

Hiroshi Saito, Chisato Hamashima, Kumiko Saika, Ryoko Machii, Kanako Kono, Ayako Aoki, Koichi Nagata, Yoshiki Ishikawa, Sayuri Amanuma, Junko Asai, Kanoko Matsushima, Kazuko Matsuda, Akiko Totake, Taeko Aiko, Asako Kowada, Masae Omaru, Ikuko Tominaga


The Division of Screening Assessment and Management has conducted studies on the assessment and management of screening programs, particularly 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 issued in 2007 and revised in 2012. Thus, our division has developed and updated screening guidelines (Cancer Screening Assessment), and constructed quality assurance systems for the screening programs (Cancer Screening Management).

Our team and what we do

Our division consists of two teams according to their responsible activities. One is the activity for developing cancer screening guidelines, and the other for Quality Assurance. H. Saito is involved in both activities. C. Hamashima is the head of the former team, and J. Asai, K. Matsushima, and I. Tominaga also belong to the team. The rest of the members are those of a latter team. In addition, H. Saito, C. Hamashima, K. Saika, K. Kono, and K. Nagata are also involved with the research activity.

Routine activities related to national anti-cancer strategy

1.Development of cancer screening guidelines and related issues

Evidence report for cervical cancer has been developed for revision of the guidelines.

English version of breast cancer screening guidelines was published.

Quality assurance manual for endoscopic screening for gastric cancer was published.

2.Quality Assurance (QA) in cancer screening at municipalities and prefectures

Our division collected the information on QA activity using the Cancer Screening Checklists (CLs) as a structure indicator in quality assurance at municipalities. CL data on status of QA activity in 2016 is being collected from all of the municipalities. In addition, our division newly started to monitor the QA status of the screening programs provided through primary care physicians, which had not been included in the survey.

Our division developed a data book on cancer screening programs in each prefecture and distributed it to all of the prefectures. The data described in the book includes those data of CLs, process indicators, and problem lists in each prefecture in terms of QA level.

Numerical standards for process indicators have been used to improve QA levels within the framework of the Basic Plan for Promotion of Cancer Control. As the process indicator values in the country was improved after introduction of the standards, in this year, revision of the original standards such as the acceptable level of each process indicator was performed using the data during the most recent 10 years. The values will be proposed as the new standard of acceptable level for each process indicator to the Cancer Screening Councile of the Ministry, Labor, Health and Welfare.

Research activities

1.A randomized controlled trial (RCT) of colonoscopic screening and other RCTs

A randomized controlled trial evaluating one-time colonoscopic screening (CS) for colorectal cancer started in 2009. Our division has been responsible for designing and managing the study as the head office. The cumulative number of subjects who gave informed consent, and who were enrolled in the study, came out at 9,747 in March 2017, corresponding to 97% of the planned number. Our division has also participated in other RCTs (breast cancer and lung cancer screening) as the member of headquarters for the research, and supported those studies.

2.A cohort study to evaluate the efficacy of cervical cancer screening using human papilloma virus in conjunction with pap smear cytology

Our division has supported the management of the study as the head office. A total of 25,081 subjects have participated in the study in the end of 2016 at 39 municipalities.

3.A cohort study to evaluate gastric cancer screening using anti- Helicobacter pyroli antibody and serum pepsinogen test in combination with gastric endoscopy

Our division started the above study in Niigata city.

Future prospects

Through the above-mentioned activities, we are aiming to contribute in achieving mortality reduction from cancer in Japan.

List of papers published in 2016


1.Ohuchi N, Suzuki A, Sobue T, Kawai M, Yamamoto S, Zheng Y-F, Shiono YN, Saito H, Kuriyama S, Tohno E, Endo T, Fukao A, Tsuji I, Yamaguchi T, Ohashi Y, Fukuda M, Ishida T. Sensitivity and specificity of mammography and adjunctive ultrasonography to screen for breast cancer in the Japan Strategic Anti-cancer Randomized Trial (J-START): a randomised controlled trial. Lancet, 387:341-348, 2016

2.Sekiguchi M, Igarashi A, Matsuda T, Matsumoto M, Sakamoto T, Nakajima T, Kakugawa Y, Yamamoto S, Saito H, Saito Y. Optimal use of colonoscopy and fecal immunochemical test for population-based colorectal cancer screening: a cost-effectiveness analysis using Japanese data. Jpn J Clin Oncol, 46:116-125, 2016

3.Hirai K, Ishikawa Y, Fukuyoshi J, Yonekura A, Harada K, Shibuya D, Yamamoto S, Mizota Y, Hamashima C, Saito H. Tailored message interventions versus typical messages for increasing participation in colorectal cancer screening among a non-adherent population: A randomized controlled trial. BMC Public Health, 16:431, 2016

4.Young GP, Senore C, Mandel JS, Allison JE, Atkin WS, Benamouzig R, Bossuyt PMM, Silva MD, Guittet L, Halloran SP, Haug U, Hoff G, Itzkowitz SH, Leja M, Levin B, Meijer GA, O'Morain CA, Parry S, Rabeneck L, Rozen P, Saito H, Schoen RE, Seaman HE, Steele RJC, Sung JJY, Winawer SJ. Recommendations for a step-wise comparative approach to the evaluation of new screening tests for colorectal cancer. Cancer, 122:826-839, 2016

5.Hamashima C, Japanese Research Group for the Development of Breast Cancer Screening Guidelines., Hamashima C, Hattori M, Honjo S, Kasahara Y, Katayama T, Nakai M, Nakayama T, Morita T, Ohta K, Ohnuki K, Sagawa M, Saito H, Sasaki S, Shimada T, Sobue T, Suto A. The Japanese Guidelines for Breast Cancer Screening. Jpn J Clin Oncol, 46:482-492, 2016

6.Hamashima C, Fukao A. Quality assurance manual of endoscopic screening for gastric cancer in Japanese communities. Jpn J Clin Oncol. 2016

7.Hamashima C. Benefits and harms of endoscopic screening for gastric cancer. World J Gastroenterol, 22:6385-6392, 2016

8.Iwano T, Nagata K, Mima A, Egawa T, Yamashita H, Saito H. Computed Tomographic Colonography Findings in Ileocecal Tuberculosis. J Gastrointestin Liver Dis, 25:269, 2016

9.Iwano T, Nagata K, Egawa T, Yamashita H. Appendiceal diverticulosis incidentally detected by computed tomographic colonography. Dig Liver Dis, 48:565, 2016


1.International Agency for Research on Cancer Handbook Working Group: [Anttila A, Armstrong B, Badwe RA, da Silva RCF, de Bock GH, de Koning HJ, Duffy SW, Ellis I, Hamashima C, Houssami N, Kristensen V, Miller AB, Murillo R, Paci E, Patnick J, Qiao YL, Rogel A, Segnan N, Shastri SS, Smith RA, Solbjor M, Thomas DB, Vainio EW, Heywang-Kobrunner SH, Yaffe MJ]. In: Breast Cancer Screening - IARC Handbook of Cancer Prevention Volume 15, International Agency for Research on Cancer, 2016