Challenges in breast and cervical cancer control in Japan.

Since the mid-1990s, there has been an increasing incidence of, and mortality from, cervical and breast cancers in Japan. Such an increase has raised concerns over the efficiency of Japan's screening programmes for these cancers. Although citizens benefit from universal health coverage, the Japanese health insurance system mostly focuses on tertiary prevention and disease treatment, while secondary prevention (screening) is low priority.

Increase of colon and rectal cancer incidence rates in Japan: trends in incidence rates in Miyagi Prefecture, 1959-1997.

Background: During recent decades, colorectal cancer incidence rates have been rapidly increasing in Japan. To investigate trends in colorectal cancer incidence rates, we analyzed incidence data during 39 years between 1959 and 1997 in Miyagi Prefecture, Japan.

Methods: Using age-period-cohort models, we evaluated the effects of time period and cohort on colon and rectal cancer incidence.

Science and ethics in epidemiology.

This article is the summary of my Special Lecture at the 14th Annual Scientific Meeting of the Japan Epidemiological Association in 2004. Epidemiology is defined as the "science of investigating the distribution of diseases in human populations and their determinants." Recent advances in study methodology, especially a widespread conduct of randomized controlled trials (RCTs), have strengthened the scientific basis of epidemiology.

Reliability and validity of the Multidimensional Health Locus of Control Scale in Japan: relationship with demographic factors and health-related behavior.

We assessed the reliability and validity of the Multidimensional Health Locus of Control Scale (MHLC scale) in a rural Japanese community. The study subjects were 2388 men and 2454 women aged 40-79 years, who completed a questionnaire regarding socio-demographics, health-related behavior, such as smoking and drinking, and the MHLC. The Cronbach alpha of the MHLC scale, which is an indicator of the internal consistency of the scale, was within the range 0.

Health practices and mortality in Japan: combined effects of smoking, drinking, walking and body mass index in the Miyagi Cohort Study.

Background: Evidence is limited regarding the association between the combinations of multiple health practices and mortality.

Methods: In 1990, 28,333 men and women in Miyagi Prefecture in rural northern Japan (40-64 year of age) completed a self-administered questionnaire. A lifestyle score was calculated by adding the number of high-risk practices (smoking, consuming > or = 22.

Body mass index and mortality in Japan: the Miyagi Cohort Study.

Background: The relation between body mass index (BMI) and mortality is not well established. The objective of this study was to examine the association in Japanese adults.

Methods: In 1990, 18,740 men and 20,870 women in Miyagi Prefecture in rural northern Japan (40-64 years of age) completed a self-administered questionnaire including height and weight.

Walking and mortality in Japan: the Miyagi Cohort Study.

Background: Although many studies in western populations demonstrated that time spent walking was associated with a reduced risk of all-cause mortality, data on Japanese has been sparse.

Methods: In 1990, 20,004 men and 21,159 women in Miyagi Prefecture in rural northern Japan (40-64 year of age) completed a self-administered questionnaire including a question on time spent walking. Cox regression was used to estimate relative risk (RR) of mortality according to three levels of walking (30 minutes or less, between 30 minutes and one hour, and one hour or more), with adjustment for age, education, marital status, past history of diseases, smoking, drinking, body mass index, and dietary variables.

Alcohol consumption and mortality in Japan: the Miyagi Cohort Study.

Background: We examined the association between alcohol consumption and all-cause mortality in Japanese men and women.

Methods: From June through August 1990, a total of 39,076 subjects (20,660 men and 18,416 women) in 14 municipalities of Miyagi Prefecture in rural northern Japan (40-64 years of age) completed a self-administered questionnaire that included information about alcohol consumption and various health habits. During 11 years of follow-up, we identified 1,879 deaths (1,335 men and 544 women).

Cigarette smoking and mortality in Japan: the Miyagi Cohort Study.

Background: We examined the association between smoking and all-cause mortality among Japanese men and women.

Methods: In 1990, 18,945 men and 17,107 women in Miyagi Prefecture in rural northern Japan (40-64 year of age) completed a self-administered questionnaire including items on smoking. Cox regression was used to estimate relative risk (RR) of mortality according to smoking categories, with adjustment for age, education, marital status, past history of diseases, drinking, body mass index, walking, and dietary variables.

Cancer incidence profiles in the Miyagi Cohort Study.

Background: There were few prospective cohort studies in Japan using cancer incidence as an endpoint.

Methods: We conducted a baseline survey with two self-administered questionnaires regarding lifestyle and personality on the residents aged 40 to 64 years in 14 municipalities of Miyagi Prefecture, Japan, during June through August, 1990. Out of the eligible 51,921 residents, 47,605 (91.

Follow-up and mortality profiles in the Miyagi Cohort Study.

Background: Findings from a large-scale population-based prospective cohort would lead us to better understanding of the relationship between lifestyle and health, thus better provision of strategies for disease prevention and health promotion.

Methods: We conducted a baseline survey with two self-administered questionnaires regarding lifestyle and personality on the residents aged 40 to 64 years in 14 municipalities of Miyagi Prefecture, Japan, during June through August, 1990. Out of the eligible 51,925 residents, 47,605 (91.

The increase of female breast cancer incidence in Japan: emergence of birth cohort effect.

During recent decades, breast cancer incidence has been increasing in Japan. According to the latest reports from several cancer registries in Japan, the breast has become the leading cancer site in female cancer incidence. To analyze the trend of breast cancer incidence in detail, we summarized female breast cancer incidence in Miyagi Prefecture, Japan during 1959-1997, and evaluated the period and cohort effect on breast cancer incidence using the age-period-cohort model.

Impact of walking upon medical care expenditure in Japan: the Ohsaki Cohort Study.

Background: Physical activity is expected to reduce medical costs by lowering the risk for a variety of chronic diseases. However, little is known about the actual magnitude of medical cost saved by physical activity. We attempted to quantify the association between time spent walking and medical care costs, based on a 4-year prospective observation of National Health Insurance (NHI) beneficiaries in rural Japan.

Personality and the risk of cancer.

Background: The role of personality in the causation of cancer has been controversial. We examined this question in a large, prospective study.

Methods: From June through August 1990, 30 277 residents of Miyagi Prefecture in northern Japan completed a Japanese version of the short form of the Eysenck Personality Questionnaire-Revised and a questionnaire on various health habits.

Screening for Gastric Cancer in Miyagi, Japan: Evaluation with a Population-Based Cancer Registry.

Mass screening for gastric cancer originated in Miyagi Prefecture, Japan, in 1960. This review summarizes studies assessing the efficacy of screening using data from a population-based cancer registry in the prefecture that was started in 1959. Sensitivity and specificity of screening photofluorography (indirect radiography) is 81.

Validation of a food-frequency questionnaire for cohort studies in rural Japan.

Objectives: To examine the validity and reproducibility of a self-administered food-frequency questionnaire (FFQ) used for two cohort studies in Japan.

Design: Cross-sectional study.

Setting: Two rural towns in the Miyagi Prefecture, in north-eastern Japan.

Diet and systemic lupus erythematosus: a 4 year prospective study of Japanese patients.

Objective: To investigate the associations of dietary factors with the occurrences of active disease and vascular damage in female patients with systemic lupus erythematosus (SLE).

Methods: Clinical and questionnaire data were collected from 279 female patients with SLE in a 1995 baseline survey. Dietary nutrients were estimated by a semiquantitative food frequency questionnaire and disease activity was evaluated based on the Lupus Activity Criteria Count.

Health expectancies in Japan: gender differences and policy implications for women.

Based on prospective observation of elderly people in the community in Japan, we compared the time-course of development and progression of physical disability between women and men. Men experienced disability at a younger age and at a faster rate than did women. The duration of time spent with disability in women was twice as long as in men.

Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study.

Objective: To examine the relationship between the normal nocturnal decline in blood pressure and the risk of cardiovascular mortality in individuals with and without high 24-h blood pressure values.

Methods: We obtained 24-h ambulatory blood pressure readings from 1542 residents of Ohasama, Japan, who were aged 40 years or more and were representative of the Japanese general population. We then followed up their survival for a mean of 9.

Validation of walking questionnaire for population-based prospective studies in Japan: comparison with pedometer.

Purpose: To assess the reproducibility and validity of a single-item, self-administered questionnaire on walking used in two population-based prospective cohort studies in northern Japan, using pedometer counts as the reference standard.

Methods: Fifty-one men and 55 women participating in the main cohort studies (mean age: 61.7 years) responded to a question on the average duration of walking per day five times at 3-month intervals.

Medical care expenditure associated with body mass index in Japan: the Ohsaki Study.

Objective: To examine the impact of body mass index (BMI) upon medical care use and its costs in Japan.

Design: A population-based prospective cohort study from 1995 to 1998.

Subjects: A cohort of 41 967 Japanese adults aged 40-79 y.

T+31C polymorphism of angiotensinogen gene and nocturnal blood pressure decline: the Ohasama study.

Background: We assessed the association between several polymorphisms of angiotensinogen gene (AGT) and essential hypertension using ambulatory blood pressure (BP).

Methods: We recruited 802 subjects in a rural Japanese community who were aged >40 years and who gave written informed consent for monitoring of their ambulatory BP and genetic analysis (the Ohasama Study). As a polymorphism of AGT, T+31C, which is in complete linkage disequilibrium with M235T, was determined using the TaqMan polymerase chain reaction method.