Research Center for Cancer Prevention and Screening

Palikir - National Government Center, Micronesia

Research Center for Cancer Prevention and Screening

Palikir - National Government Center, Micronesia

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Hamashima C.,Research Center for Cancer Prevention and Screening
World Journal of Gastroenterology | Year: 2014

Gastric cancer remains the second leading cause of cancer death worldwide. About half of the incidence of gastric cancer is observed in East Asian countries, which show a higher mortality than other countries. The effectiveness of 3 new gastric cancer screening techniques, namely, upper gastrointestinal endoscopy, serological testing, and "screen and treat" method were extensively reviewed. Moreover, the phases of development for cancer screening were analyzed on the basis of the biomarker development road map. Several observational studies have reported the effectiveness of endoscopic screening in reducing mortality from gastric cancer. On the other hand, serologic testing has mainly been used for targeting the high-risk group for gastric cancer. To date, the effectiveness of new techniques for gastric cancer screening has remained limited. However, endoscopic screening is presently in the last trial phase of development before their introduction to population-based screening. To effectively introduce new techniques for gastric cancer screening in a community, incidence and mortality reduction from gastric cancer must be initially and thoroughly evaluated by conducting reliable studies. In addition to effectiveness evaluation, the balance of benefits and harms must be carefully assessed before introducing these new techniques for population-based screening. © 2014 Baishideng Publishing Group Inc. All rights reserved.


Gotoda T.,National Cancer Center Hospital | Iwasaki M.,Research Center for Cancer Prevention and Screening | Kusano C.,National Cancer Center Hospital | Seewald S.,Gastroenterology Center | Oda I.,National Cancer Center Hospital
British Journal of Surgery | Year: 2010

Background: Criteria for endoscopic resection in patients with early gastric cancer (EGC) have been expanded recently by the National Cancer Centre (NCC). This study compared long-term outcomes in patients with EGC who underwent endoscopic treatment according to guideline criteria with those treated according to expanded criteria. Methods: Baseline and outcome data from patients undergoing curative endoscopic resection for EGC between January 1999 and December 2005 were collected from electronic medical records. Survival time hazard ratios and 95 per cent confidence intervals were calculated using the Cox proportional hazards model. Results: Of 1485 patients who had a curative resection, 635 (42.8 per cent) underwent resection according to traditional criteria and 625 (42.1 percent) according to expanded criteria. There was no significant difference in overall survival between the groups. Conclusion: Patients who have treatment following the expanded criteria have similar long-term survival and outcomes to those treated according to guideline criteria. Copyright © 2010 British Journal of Surgery Society Ltd.


Tsugane S.,Research Center for Cancer Prevention and Screening | Inoue M.,Research Center for Cancer Prevention and Screening
Cancer Science | Year: 2010

Over the last 60 years, Japanese people have experienced a rapid and drastic change in lifestyle, including diet. Suspicions have been raised that so-called 'Westernization', characterized by a high-calorie diet and physical inactivity, is associated with increasing trends in the incidence of cancer of the colon, liver, pancreas, prostate, and breast, as well as type 2 diabetes. Epidemiological evidence from our prospective study, the Japan Public Health Center-based Prospective (JPHC) study, and systematic literature reviews generally support the idea that factors related to diabetes or insulin resistance are associated with an increased risk of colon (mostly in men), liver, and pancreatic cancers. These cancers are inversely associated with physical activity and coffee consumption, which are known to decrease the risk of type 2 diabetes. The suggested mechanism of these effects is that insulin resistance and the resulting chronic hyperinsulinemia and increase in bioavailable insulin-like growth factor 1 (IGF1) stimulate tumor growth. In contrast, associations with diabetes are less clear for cancer of the colon in women, and breast and prostate, which are known to be related to sex hormones. The effect of insulin resistance or body fat on sex-hormone production and bioavailability may modify their carcinogenic effect differently from cancers of the colon in men, and liver and pancreas. In conclusion, there is substantial evidence to show that cancers of the colon, liver, and pancreas are associated with insulin resistance, and that these cancers can be prevented by increasing physical activity, and possibly coffee consumption. © 2010 Japanese Cancer Association.


Tsugane S.,Research Center for Cancer Prevention and Screening
Journal of Gastroenterology and Hepatology (Australia) | Year: 2012

The health impact of alcohol drinking, cigarette smoking and obesity differs between Asian and Western countries. The epidemiology of cancer and death related to these lifestyles are described in this article. In Japan, heavy alcohol drinking and cigarette smoking are rather high in men. While there is a worldwide anti-smoking policy, Japan is still on the way to aiming at this goal, and this delay in health promotion has maintained the high impact of smoking, whether active or passive, on people's health in that country. Public health policy should focus more strongly on the control of smoking and heavy drinking, especially among men. Maintaining the consumption of alcohol at a level below 46g a day in men and 23g a day in women appears to minimize the risks of mortality and cancer in the Japanese population. On the other hand, the obesity rate is low and being underweight is common both in men and women. Proportions of cancer attributable to a body mass index of 25 or more are only 0.5% in men and 1.1% in women. Given that many previous studies in Japanese and Asian populations have associated a low body mass index with an increased risk of cancer, the impact of being underweight-not only obese-may warrant further investigation. © 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.


Iwasaki M.,Research Center for Cancer Prevention and Screening | Tsugane S.,Research Center for Cancer Prevention and Screening
Cancer Science | Year: 2011

Although our understanding of the etiology of breast cancer has improved, many well-known risk factors are not modifiable and present knowledge has proved insufficient to allow the disease to be overcome. Indeed, incidence and mortality among Japanese women have increased over the past three decades. Here, we review epidemiological evidence from our cohort and case-control studies among Japanese women in comparison with other published findings. Our studies confirm the important role of established factors derived primarily from Western populations, such as menstrual and reproductive factors, anthropometric factors, physical activity, and alcohol intake, in the development of breast cancer. In addition, we provide further evidence to better understand the role of traditional Japanese foods in the etiology of breast cancer. Our cohort study found that a higher intake of isoflavone and higher levels of plasma genistein, but not daidzein, were associated with a decreased risk of breast cancer. Our case-control studies reveal a dose-response pattern for these compounds; specifically, decreased risk as women move from "no" to "moderate" intake and leveling off thereafter. In addition, gene-environment interactions have been revealed in the effects of isoflavones. The evidence reviewed suggests that isoflavone has a protective effect against breast cancer in Asian populations. Conversely, our cohort study did not observe an inverse association between breast cancer risk and the intake of green tea and/or the plasma level of tea polyphenols, but we did find an association between increased risk and active and passive smoking. In conclusion, based on current knowledge, primary prevention according to individual lifestyle modification should focus on alcohol intake, weight control, physical activity, and tobacco smoking. © 2011 Japanese Cancer Association.


Yamaji T.,Research Center for Cancer Prevention and Screening | Iwasaki M.,Research Center for Cancer Prevention and Screening | Sasazuki S.,Research Center for Cancer Prevention and Screening | Tsugane S.,Research Center for Cancer Prevention and Screening
Cancer Research | Year: 2010

Obesity has been associated with an increased risk of colorectal neoplasia, but the mechanisms of this potential association have not been elucidated. We hypothesized that the adipokines adiponectin, leptin, and tumor necrosis factor-α (TNF-α) may mediate an association between obesity and colorectal cancer. We measured plasma concentrations of total and high-molecular-weight (HMW) adiponectin, leptin, and TNF-á in healthy volunteer examinees who underwent total colonoscopy between February 2004 and February 2005, and conducted a case-control study consisting of 778 cases and 735 controls. An inverse association of total and HMW adiponectin was observed with colorectal adenoma (P trend < 0.001 and 0.03, respectively). Further, total adiponectin interacted with leptin, but not TNF-α, in relation to colorectal adenoma (P interaction = 0.007). An inverse association of total adiponectin with colorectal adenoma was apparent in the highest two tertiles of leptin, particularly the middle (P trend < 0.001), whereas a positive association of leptin was obvious in the lowest tertile of total adiponectin (P trend = 0.01) after adjusting for potential confounders and body mass index, which is a major determinant of insulin resistance. Adiponectin may exert an anticarcinogenic effect on the large intestine by interfering with leptin, whereas leptin could conversely exert a carcinogenic effect under conditions of a lower abundance of adiponectin. Our findings provide the first epidemiologic evidence for interactive effects of adiponectin and leptin in the early stage of colorectal tumorigenesis, distinct from their involvement in insulin resistance. ©2010 AACR.


Tsugane S.,Research Center for Cancer Prevention and Screening | Sawada N.,Research Center for Cancer Prevention and Screening
Japanese Journal of Clinical Oncology | Year: 2014

The Japan Public Health Center-based prospective Study conducted a baseline survey for 140 000 registered residents aged 40-69 years within 11 public health center areas nationwide in 1990-94. Five- and 10-year follow-up surveys were conducted to update information on lifestyle habits and health conditions. In total, 130 000 participants responded to at least one of the three questionnaire surveys, and 78 000 to all three. In addition, 60 000 participants provided blood samples on at least one of the two sampling times, and 23 000 on both. The subjects have been followed for vital status and the occurrence of cancer and other diseases. As of December 2011, 24 000 deaths have been documented, as well as 17 000 cases of cancer, 6000 cases of stroke and 1100 cases of myocardial infarction. We have tested the association between potential causal factors and the incidence of or mortality from cancer and other diseases, and published >250 papers to date. Typical dietary habits in Japan are high consumption of soy/isoflavones, fish/n-3 fatty acids, salt/salted foods and green tea, and low consumption of red meat and saturated fat. This paper briefly summarizes the observed associations of these foods/nutrients with cancer, cardiovascular diseases and diabetes. The Japan Public Health Center-based prospective Study is scheduled to conduct active follow-up for a total of 30 years, and we plan to publish additional evidence on the potential causes of a shorter life and major disease occurrence. © 2014 The Author. Published by Oxford University Press. All rights reserved.


Goto A.,Diabetes Research Center | Goto M.,Diabetes Research Center | Noda M.,Diabetes Research Center | Tsugane S.,Research Center for Cancer Prevention and Screening
PLoS ONE | Year: 2013

Background:The definition of incident type 2 diabetes varies across studies; hence, the actual incidence of type 2 diabetes in Japan is unclear. Here, we reviewed the various definitions of incident type 2 diabetes used in previous epidemiologic studies and estimated the diabetes incidence rate in Japan.Methods:We searched for related literature in the MEDLINE, EMBASE, and Ichushi databases through September 2012. Two reviewers selected studies that evaluated incident type 2 diabetes in the Japanese population.Results:From 1824 relevant articles, we included 33 studies with 386,803 participants. The follow-up period ranged from 2.3 to 14 years and the studies were initiated between 1980 and 2003. The random-effects model indicated that the pooled incidence rate of diabetes was 8.8 (95% confidence interval, 7.4-10.4) per 1000 person-years. We observed a high degree of heterogeneity in the results (I2 = 99.2%; p < 0.001), with incidence rates ranging from 2.3 to 52.6 per 1000 person-years. Three studies based their definition of incident type 2 diabetes on self-reports only, 10 on laboratory data only, and 20 on self-reports and laboratory data. Compared with studies defining diabetes using laboratory data (n = 30; pooled incidence rate = 9.6; 95% confidence interval = 8.3-11.1), studies based on self-reports alone tended to show a lower incidence rate (n = 3; pooled incidence rate = 4.0; 95% confidence interval = 3.2-5.0; p for interaction < 0.001). However, stratified analyses could not entirely explain the heterogeneity in the results.Conclusions:Our systematic review and meta-analysis indicated the presence of a high degree of heterogeneity, which suggests that there is a considerable amount of uncertainty regarding the incidence of type 2 diabetes in Japan. They also suggested that laboratory data may be important for the accurate estimation of the incidence of type 2 diabetes. © 2013 Goto et al.


Inoue M.,Research Center for Cancer Prevention and Screening
Journal of Epidemiology | Year: 2010

In Japan, cancer has long been recognized as a major component of the overall pattern of disease. Currently, there is a need to implement practical control measures with specific numerical targets appropriate for the Japanese population. Using data from the Japan Public Health Center-based Prospective Study, the author estimated the impact of major risk factors on overall cancer risk among a Japanese population. These risk factors included tobacco smoking, alcohol drinking, body mass index, history of diabetes, physical activity, and metabolic factors and their aggregates. The results show that tobacco smoking and heavy alcohol drinking were significantly positively associated with overall cancer risk, and that total physical activity was significantly inversely associated with the risk of cancer. Although people with a history of diabetes may be at increased risk of cancer, extreme body mass index and metabolic factors in the aggregate had little impact on overall cancer risk in the Japanese population. Copyright © 2010 by the Japan Epidemiological Association.


Sano H.,Shiga University | Goto R.,Kyoto University | Hamashima C.,Research Center for Cancer Prevention and Screening
Asian Pacific Journal of Cancer Prevention | Year: 2014

Background: Cancer screening rates in Japan are much lower than those in Western countries. This study evaluated the relationship between cancer screening rates and strategies used to improve screening rates, and determined which strategy is the most effective. Materials and Methods: All municipalities are responsible for conducting gastric, lung, colorectal, cervical, and breast cancer screenings in Japan. Of the 1,746 municipalities in total, 92-99% were included in the analyses for each cancer screening. Using national data in 2009, the correlations between cancer screening rates and strategies for improving screening rates of all municipalities, both large (populations of over 30,000) and small (populations of under 30,000), were determined. The strategies used were as follows: sending personal invitation letters, personal visits by community health workers, use of a clinical setting for screening, and free screening. Results: Of all four strategies used to improve cancer screening rates, sending personal invitation letters had the highest correlations with all screening rates, with the exception of breast cancer screening. The partial correlation coefficients linking this strategy with the screening rates in all municipalities were 0.28, 0.32, 0.30, and 0.26 for gastric, lung, colorectal, and cervical cancer screening, respectively. In large municipalities, the correlations between the number of examinees in a clinical setting and the screening rates were also relatively high, particularly for cervical cancer screening (r=0.41). Conclusions: Sending personal invitation letters appears to be particularly effective in improving cancer screening rates in all municipalities. All municipalities should implement a system that sends personal invitation letters for cancer screening. In large municipalities, increasing the availability of screening in a clinical setting is also effective in improving cancer screening rates.

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