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Inoue M.,Research Center for Cancer Prevention and Screening | Tsugane S.,Research Center for Cancer Prevention and Screening | Sobue T.,National Cancer Center | Hanaoka T.,National Cancer Center | And 99 more authors.
Journal of Epidemiology and Community Health | Year: 2011

Background: Few studies have examined the impact of weight change in different periods of lifetime on type 2 diabetes risk, and the association of weight loss with type 2 diabetes is unclear. We prospectively investigated the association of weight change since age 20 y and that during middle-to-late adulthood with the incidence of type 2 diabetes. Methods: Subjects were 52 014 men and women aged 45-75 y who participated in the Japan Public Health Center-Based Prospective Study and had no history of diabetes. ORs of self-reported physician-diagnosed type 2 diabetes for weight change between age 20 y and baseline survey (mean age 50.6 y) and during 5 y between baseline and second surveys were estimated using logistic regression analysis. Results: During the 5-year period following 5-year survey, 989 newly diagnosed cases of type 2 diabetes were self-reported. Weight gain from age 20 y was associated with an increased risk of type 2 diabetes. The multivariate-adjusted OR (95% CI) for a weight gain of ≥5 kg versus a stable weight were 2.61 (2.11 to 3.23) in men and 2.56 (1.95 to 3.35) in women. A weight gain of ≥5 kg over the 5-y following the baseline survey was also associated with an increased risk in women. No association with weight loss was observed for either period. Conclusions: These results suggest that long-term weight gain from early adulthood to middle-age increases risk of type 2 diabetes in men and women and that risk is further enhanced by weight gain in later life in women.


Kimura T.,Osaka University | Iso H.,Osaka University | Honjo K.,Osaka University | Ikehara S.,Osaka University | And 132 more authors.
Journal of Epidemiology | Year: 2016

Background: Suicide rates have been related to educational level and other socioeconomic statuses. However, no prospective study has examined the association between educational level and the risk of suicide in Japan. Methods: We examined the association of education level and suicide risk in a population-based cohort of Japanese men and women aged 40-59 years in the Japan Public Health Center-based Prospective Study Cohort I. In the baseline survey initiated in 1990, a total of 46 156 subjects (21 829 men and 24 327 women) completed a selfadministered questionnaire, which included a query of educational level, and were followed up until the end of December 2011. Educational levels were categorized into four groups (junior high school, high school, junior or career college, and university or higher education). During a median follow-up of 21.6 years, the hazard ratios (HRs) and 95% confidence intervals (CIs) of suicide according to educational level were estimated using the Cox proportional hazards regression model adjusted for age; study area; previous history of stroke, ischemic heart disease, or cancer; self-reported stress; alcohol consumption; smoking; living with spouse; and employment status. A total of 299 deaths attributed to suicide occurred. Results: The HR for university graduates or those with higher education versus junior high school graduates was 0.47 (95% CI, 0.24-0.94) in men, and that for high school graduates versus junior high school graduates was 0.44 (95% CI, 0.24-0.79) in women. Conclusions: High educational levels were associated with a reduced risk of suicide for both Japanese men and women. © 2016 Takashi Kimura et al.


Hanibuchi T.,Chukyo University | Nakaya T.,Ritsumeikan University | Honjo K.,Osaka University | Ikeda A.,Epidemiology and Prevention Group | And 141 more authors.
Health and Place | Year: 2015

The purpose of this study is to explore neighborhood contextual factors in terms of smoking behaviors among middle-aged Japanese, by using a multilevel analysis. Subjects were Japanese men and women, between 40 and 59 years of age (40,961 for the cross-sectional analysis, and 9,177 for the longitudinal analysis), nested in 39 neighborhoods (. Kyuson). The results showed that women in a less residentially stable neighborhood were more likely to be smokers. No associations were seen between current smoking and neighborhood deprivation; however, women in the most deprived neighborhood were more likely to quit smoking. This study is the first to demonstrate the associations between neighborhood environment and current smoking or smoking cessation, in a Japanese setting. The findings imply that policy makers should consider targeting neighborhood conditions in order to help reduce smoking prevalence, especially among women. © 2014 Elsevier Ltd.


Suzuki R.,Research Center for Cancer Prevention and Screening | Iwasaki M.,Research Center for Cancer Prevention and Screening | Inoue M.,Research Center for Cancer Prevention and Screening | Inoue M.,National Cancer Center | And 105 more authors.
International Journal of Cancer | Year: 2010

Epidemiological studies have evaluated whether the impact of alcohol intake on breast cancer risk is modified by use of exogenous estrogens, folate intake, body weight and smoking status, but results have been inconsistent. Further, effect modification by intake of isoflavones and alcohol-induced facial flushing, which are prevalent in Asian populations, have not been investigated. We investigated the association between alcohol intake and breast cancer risk and whether the association is modified by these factors among 50,757 premenopausal and postmenopausal women (aged 40-69 years) in the population-based Japan Public Health Center-based Prospective Study. Alcohol consumption and other related factors were assessed using self-reported questionnaires. Through to the end of 2006, 572 patients were identified. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated by hazard ratios derived from Cox proportional hazards regression models. Compared with never-drinkers, regular alcohol drinkers (>150 g of ethanol/week) had a higher risk of the development of breast cancer; the multivariable-adjusted RRs were 1.75 (95% CI = 1.16-2.65; ptrend 5 0.035) for overall, 1.78 (95% CI = 1.09-2.90) for premenopausal and 1.21 (95% CI = 0.53-2.75) for postmenopausal women. There was no statistical evidence for effect modification by menopausal status, use of exogenous estrogens, intakes of isoflavone and folate, body weight, alcohol-induced facial flushing or smoking (All p interactions ≥ 0.15). Excessive alcohol intake was associated with an increase in the risk of breast cancer in this population. There was no statistical evidence for effect modification. © 2009 UICC.


Michikawa T.,Japan National Institute of Environmental Studies | Michikawa T.,Research Center for Cancer Prevention and Screening | Inoue M.,Research Center for Cancer Prevention and Screening | Sawada N.,Research Center for Cancer Prevention and Screening | And 118 more authors.
Preventive Medicine | Year: 2012

Objective: The purpose of the present study was to develop a risk estimation model for the 10-year risk of hepatocellular carcinoma (HCC) that could be easily used in a general population to aid in the prevention of HCC. Methods: Our prediction model was derived from data obtained on 17,654 Japanese aged 40 to 69. years who participated in health checkups (follow-up: 1993-2006). Cox proportional hazards regression was applied to obtain coefficients for each predictor. Results: During follow-up, a total of 104 cases of HCC were newly diagnosed. After checking the model fit, we incorporated age, sex, alcohol consumption, body mass index, diabetes, coffee consumption, and hepatitis B and C virus infection into the prediction model. The model showed satisfactory discrimination (Harrell's c-index = 0.94) and was well calibrated (the overall observed/expected ratio = 1.03, 95% confidence interval = 0.83-1.29). We also developed a simple risk scoring system. Those subjects with total scores of 17 or more under this system (score range: - 1 to 19) had an estimated 10-year HCC risk of over 90%; those with 4 points or less had an estimated risk of less than 0.1%. Conclusion: We developed a simple 10-year risk prediction model for HCC in the Japanese general population as a public education tool. © 2012 Elsevier Inc.


Honjo K.,Osaka University | Iso H.,Osaka University | Iwata M.,Osaka University | Cable N.,University College London | And 90 more authors.
Journal of Epidemiology | Year: 2012

Background: Analysis of the effects of social gradients on women's health requires a suitable means of assessing social standing. Methods: We compared social gradients in stroke risk among 9317 married Japanese women from the Japan Public Health Center-based Prospective Study over a 16-year period. Social gradient was estimated by 3 methods of indicating social position: education level derived by using the individual approach (woman's own educational level), the conventional approach (using her partner's educational level), and the combined approach (combining the woman's and her partner's educational levels). Results: As compared with the lowest educational group, stroke risk was similar among women in the highest educational group using the individual approach and lower, but not significantly so, with the conventional approach. With the combined approach, however, the age- and area-adjusted hazard ratio (HR) was significantly lower among the highest education group as compared with the lowest group (HR = 0.52, 95% CI: 0.36, 0.76), and the relative index of inequality was significant (RII = 0.48, 95% CI: 0.32, 0.72). Using the combined approach, the results were similar irrespective of employment status. In the combined highest educational group, stroke risk among unemployed women was significantly reduced by 54%, while stroke risk for employed women was significantly reduced by 46%, as compared with the lowest educational group, with RIIs of 0.42 (95% CI: 0.21, 0.85) and 0.49 (0.30, 0.80), respectively. Conclusions: The results suggest that a combined approach better reflects social standing among married women in Japan.© 2012 by the Japan Epidemiological Association.


Hidaka A.,Epidemiology and Prevention Group | Sasazuki S.,Epidemiology and Prevention Group | Sasazuki S.,National Cancer Center | Matsuo K.,Kyushu University | And 135 more authors.
Carcinogenesis | Year: 2014

The association between alcohol consumption, genetic polymorphisms of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) and gastric cancer risk is not completely understood. We investigated the association between ADH1B (rs1229984), ADH1C (rs698) and ALDH2 (rs671) polymorphisms, alcohol consumption and the risk of gastric cancer among Japanese subjects in a population-based, nested, case-control study (1990-2004). Among 36 745 subjects who answered the baseline questionnaire and provided blood samples, 457 new gastric cancer cases matched to 457 controls were used in the analysis. The odds ratios (OR) and corresponding 95% confidence intervals (CI) were calculated using logistic regression models. No association was observed between alcohol consumption, ADH1B (rs1229984), ADH1C (rs698) and ALDH2 (rs671) polymorphisms and gastric cancer risk. However, considering gene-environmental interaction, ADH1C G allele carriers who drink ≥150 g/week of ethanol had a 2.5-fold increased risk of gastric cancer (OR = 2.54, 95% CI = 1.05-6.17) relative to AA genotype carriers who drink 0 to <150 g/week (P for interaction = 0.02). ALDH2 A allele carriers who drink ≥150 g/week also had an increased risk (OR = 2.08, 95% CI = 1.05-4.12) relative to GG genotype carriers who drink 0 to < 150 g/week (P for interaction = 0.08). To find the relation between alcohol consumption and gastric cancer risk, it is important to consider both alcohol consumption level and ADH1C and ALDH2 polymorphisms. © The Author 2014.


Abe S.K.,University of Tokyo | Inoue M.,University of Tokyo | Inoue M.,Research Center for Cancer Prevention and Screening | Sawada N.,Research Center for Cancer Prevention and Screening | And 129 more authors.
British Journal of Cancer | Year: 2014

Background:Colorectal cancer (CRC) incidence rate increased rapidly in Japan between the 1950s and 1990s. We examined the association between rice intake and CRC risk in comparison with bread, noodles and cereal among Japanese adults enrolled in the Japan Public Health Center-based prospective Study.Methods:A total of 73 501 Japanese men and women were followed-up from 1995 to 1999 until the end of 2008 for an average of 11 years. During 801 937 person-years of follow-up, we identified 1276 incident cases of CRC. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) of CRC for rice, noodle, bread and cereal intake were calculated by Cox proportional hazards model.Results:Overall, no significant association was observed for the highest quartile of rice intake compared with the lowest and the risk of CRC and its subsites in men (HR, 0.77; 95% CI, 0.56-1.07) and women (HR, 1.10; 95% CI, 0.71-1.68). However, a non-significant inverse trend was observed between rice intake and rectal cancer in men. No clear patterns of association were observed in bread, noodle and cereal intake.Conclusion:Our findings suggest that the consumption of rice does not have a substantial impact on the risk of CRC in the Japanese population. © 2014 Cancer Research UK.


Saito E.,Epidemiology and Prevention Group | Saito E.,University of Tokyo | Inoue M.,Epidemiology and Prevention Group | Inoue M.,University of Tokyo | And 137 more authors.
Annals of Epidemiology | Year: 2015

Purpose: We examined the association between green tea consumption and mortality due to all causes, cancer, heart disease, cerebrovascular disease, respiratory disease, injuries, and other causes of death in a large-scale population-based cohort study in Japan. Methods: We studied 90,914 Japanese (aged between 40 and 69years) recruited between 1990 and 1994. After 18.7years of follow-up, 12,874 deaths were reported. The association between green tea consumption and risk of all causes and major causes of mortality was assessed using the Cox proportional hazards regression model with adjustment for potential confounders. Results: Hazard ratios for all-cause mortality among men who consumed green tea compared with those who drank less than 1 cup/day were 0.96 (0.89-1.03) for 1-2 cups/day, 0.88 (0.82-0.95) for 3-4 cups/day, and 0.87 (0.81-0.94) for more than 5 cups/day (P for trend <.001). Corresponding hazard ratios for women were 0.90 (0.81-1.00), 0.87 (0.79-0.96), and 0.83 (0.75-0.91; P for trend <.001). Green tea was inversely associated with mortality from heart disease in both men and women and mortality from cerebrovascular disease and respiratory disease in men. No association was found between green tea and total cancer mortality. Conclusions: This prospective study suggests that the consumption of green tea may reduce the risk of all-cause mortality and the three leading causes of death in Japan. © 2015 Elsevier Inc.


Honjo K.,Osaka University | Iso H.,Osaka University | Nakaya T.,Ritsumeikan University | Hanibuchi T.,Chukyo University | And 132 more authors.
Journal of Epidemiology | Year: 2015

Background: Neighborhood deprivation has been shown in many studies to be an influential factor in cardiovascular disease risk. However, no previous studies have examined the effect of neighborhood socioeconomic conditions on the risk of stroke in Asian countries. Methods: This study investigated whether neighborhood deprivation was associated with the risk of stroke and stroke death using data from the Japan Public Health Center-based Prospective Study. We calculated the adjusted hazard ratios of stroke mortality (mean follow-up, 16.4 years) and stroke incidence (mean follow-up, 15.4 years) according to the area deprivation index (ADI) among 90 843 Japanese men and women aged 40-69 years. A Cox proportional-hazard regression model using a shared frailty model was applied. Results: The adjusted hazard ratios of stroke incidence, in order of increasing deprivation with reference to the least deprived area, were 1.16 (95% CI, 1.04-1.29), 1.12 (95% CI, 1.00-1.26), 1.18 (95% CI, 1.02-1.35), and 1.19 (95% CI, 1.01-1.41), after adjustment for individual socioeconomic conditions. Behavioral and psychosocial factors attenuated the association, but the association remained significant. The associations were explained by adjusting for biological cardiovascular risk factors. No significant association with stroke mortality was identified. Conclusions: Our results indicate that the neighborhood deprivation level influences stroke incidence in Japan, suggesting that area socioeconomic conditions could be a potential target for public health intervention to reduce the risk of stroke. © 2015 Kaori Honjo et al.

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