Annual Report 2021
Division of Screening Assessment and Management
Tomio Nakayama, Hirokazu Takahashi, Satoyo Hosono, Akiko Matsumoto, Noriaki Takahashi, Jin Miyazawa, Sayo Aikawa, Nao Ida, Miho Kashikura, Akiko Totake, Kanna Higuchi, Kanoko Matsushima
Introduction
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. 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 N. Takahashi and J. Miyazawa manage the prospective studies for evaluation of cancer screening and A. Totake, K. Higuchi and S. Aikawa assist the studies. S. Hosono manages the development of cancer screening guidelines and K. Matsushima, M. Kashikura and N. Ida assist the work. H. Takahashi is involved in the latter team (quality assurance).
Research activities
Cancer Screening Assessment
1) Studies to evaluate the effectiveness of cancer screening
A randomized controlled trial (Akita pop-colon trial) to evaluate screening for colon cancer using total colonography has finished recruiting volunteers. A follow up study is ongoing using a demographic survey and national cancer registry, and a sub-study about the sensitivity of total colonography has started.
A cohort study to evaluate screening for cervical cancer using an HPV test and Pap smear performed the fourth round screening for participants registered in 2015 and final analysis was planned.
As a follow-up team for an ongoing randomized controlled trial (JEC study) of lung cancer screening using low-dose CT, the registered cases up to 2015 were matched with regional cancer registries and cross-checked with the certificates of residence.
2) Development of cancer screening guidelines and related issues
As an evidence report on colorectal cancer screening, we evaluated the effectiveness of total colonography using two methods, the accuracy evaluation stacking method and observational studies, and summarized the evidence for total colonography. As an evidence report on lung cancer screening, we evaluated the benefits and harms of low-dose CT screening in heavy smokers. Colorectal and lung cancer screening guideline committees were formed and started to discuss the issue.
3) Dissemination and implementation of cancer screening
The reasons for the widespread use of cervical self-collection cytology without evidence in workplace screening were assessed using a mixed quantitative and qualitative research method. Lack of access to appropriate information and a tendency to be reluctant to discontinue the service once it was introduced were observed.
Quality assurance of cancer screening
1) Process Indicators
Process indicators are one of the quality assessment indicators for cancer screening, but they have not been revised since 2008. In order to correct the gap with the current situation, where improvements have been seen, the desired sensitivity and specificity were set for each organ, and based on them, new reference values for the positive rate, compliance rate of further examination and detection rate were examined and compiled.
2) Development of accuracy assessment methods for cancer screening in occupational health checkups
In preparation for the integration of population screening and occupational screening, we established a logic to extract cancer patients and those who underwent a thorough diagnostic examination using health insurance claims data in occupational health checkups. We will evaluate its validity for future implementation.
3) Impact of COVID-19 infection on cancer screening and cancer treatment
In the evaluation of the impact of COVID-19 on cancer screening and cancer treatment, data on the screening rates, the incidence of cancer, and the number of surgeries were collected and reviewed in FY2020, and the results were reported at the Cancer Control Promotion Council and other meetings.
Future Prospects
We will continue to follow up on the studies to evaluate the effectiveness of screening. In the development of screening guidelines, work will continue on the release of colorectal cancer screening and lung cancer screening guidelines. For accuracy control, we plan to finalize the draft revision of process indicators for population-based screening and release it. For the workplace screening, we will verify the validity of the quality assessment tool using health insurance claims, and promote it. The survey on the impact of COVID-19 on cancer screening and cancer treatment will continue to be conducted in FY2021.
List of papers published in 2021
Journal
1. Kamo KI, Fukui K, Ito Y, Nakayama T, Katanoda K. How much can screening reduce colorectal cancer mortality in Japan? Scenario-based estimation by microsimulation. Japanese journal of clinical oncology, 52:221-226, 2022
2. Hiramatsu K, Ueda Y, Yagi A, Morimoto A, Egawa-Takata T, Nakagawa S, Kobayashi E, Kimura T, Kimura T, Minekawa R, Hori Y, Sato K, Morii E, Nakayama T, Tanaka Y, Terai Y, Ohmichi M, Ichimura T, Sumi T, Murata H, Okada H, Nakai H, Matsumura N, Mandai M, Saito J, Horikoshi Y, Takagi T, Enomoto T, Shimura K. The efficacy of human papillomavirus vaccination in young Japanese girls: the interim results of the OCEAN study. Human vaccines & immunotherapeutics, 18:1951098, 2022
3. Yagi A, Ueda Y, Ikeda S, Miyoshi A, Nakagawa S, Hiramatsu K, Kobayashi E, Kimura T, Ito Y, Nakayama T, Nakata K, Morishima T, Miyashiro I, Kimura T. Improved long-term survival of corpus cancer in Japan: A 40-year population-based analysis. International journal of cancer, 150:232-242, 2022
4. Yoshida N, Mano Y, Matsuda T, Sano Y, Inoue K, Hirose R, Dohi O, Itoh Y, Goto A, Sobue T, Takeuchi Y, Nakayama T, Muto M, Ishikawa H. Complications of colonoscopy in Japan: An analysis using large-scale health insurance claims data. Journal of gastroenterology and hepatology, 36:2745-2753, 2021
5. Hamashima C, Sasaki S, Hosono S, Hoshi K, Katayama T, Terasawa T. National Data Analysis and Systematic Review for Human Resources for Cervical Cancer Screening in Japan. Asian Pacific journal of cancer prevention: APJCP, 22:1695-1702, 2021
6. Yagi A, Ueda Y, Nakagawa S, Masuda T, Miyatake T, Ikeda S, Abe H, Hirai K, Sekine M, Miyagi E, Enomoto T, Nakayama T, Kimura T. A nationwide birth year-by-year analysis of effectiveness of HPV vaccine in Japan. Cancer science, 112:3691-3698, 2021
7. 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. Journal of gynecologic oncology, 32:e29, 2021