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Background: Unlike many North American and European countries, Japan has observed a continuous increase in cancer incidence over the last few decades. We examined the most recent trends in population-based cancer incidence and mortality in Japan. Methods: National cancer mortality data between 1958 and 2018 were obtained from published vital statistics. Cancer incidence data between 1985 and 2015 were obtained from high-quality population-based cancer registries maintained by three prefectures (Yamagata, Fukui, and Nagasaki). Trends in age-standardized rates (ASR) were examined using Joinpoint regression analysis. Results: For males, all-cancer incidence increased between 1985 and 1996 (annual percent change [APC] +1.1%; 95% confidence interval [CI], 0.7–1.5%), increased again in 2000–2010 (+1.3%; 95% CI, 0.9–1.8%), and then decreased until 2015 (−1.4%; 95% CI, −2.5 to −0.3%). For females, all-cancer incidence increased until 2010 (+0.8%; 95% CI, 0.6–0.9% in 1985–2004 and +2.4%; 95% CI, 1.3–3.4% in 2004–2010), and stabilized thereafter until 2015. The post-2000 increase was mainly attributable to prostate in males and breast in females, which slowed or levelled during the first decade of the 2000s. After a sustained increase, all-cancer mortality for males decreased in 1996–2013 (−1.6%; 95% CI, −1.6 to −1.5%) and accelerated thereafter until 2018 (−2.5%; 95% CI, −2.9 to −2.0%). All-cancer mortality for females decreased intermittently throughout the observation period, with the most recent APC of −1.0% (95% CI, −1.1 to −0.9%) in 2003–2018. The recent decreases in mortality in both sexes, and in incidence in males, were mainly attributable to stomach, liver, and male lung cancers. Conclusion: The ASR of all-cancer incidence began decreasing significantly in males and levelled off in females in 2010.

In most high‐resource countries with organized screening programs, the incidence and mortality of cervical cancer is decreasing. Recent statistics have also revealed a reduction in invasive cervical cancer incidence as a result of national vaccination programs. Paradoxically, cervical cancer incidence has increased in Japan, particularly amongst women of reproductive age. This study aimed to examine the trends in cervical cancer incidence and mortality for young and middle adult women in Japan, by analyzing trends in 10‐year interval age‐groups. Cervical cancer incidence for young and middle adult women (ages 20‐59 years) was obtained from high‐quality population‐based cancer registries in three prefectures from 1985 to 2015. National cancer mortality data were obtained from published vital statistics from 1985 to 2019. Trends in crude and age‐standardized rates (ASR) were analyzed using Joinpoint regression. The cervical cancer incidence trend in 20‐59‐year‐old women combined significantly increased over the observation period. Both crude and ASR increased from 1985 to 2015 with an annual percent change (APC) of +1.6% (95% confidence interval, 1.1, 2.1) and +1.7% (1.2, 2.3), respectively. Similar increases were seen in ages 20‐29, 30‐39, and 40‐49 years with higher APCs especially in 20s and 30s. Both crude and ASR mortality significantly increased after the early 1990s in ages 20‐59 years combined. Based on the recognition that current cervical cancer control strategies in Japan have not been effective in reducing the cervical cancer burden in young and middle adults, promotion of screening and vaccination should be urgently strengthened. Trends in incidence and mortality of cervical cancer in young and middle‐aged women in Japan were analyzed by 10‐year interval age‐groups using long‐term high‐quality data. Incidence and mortality showed significant increase in young and middle adults from ages 20 to 59 years old. These results emphasize the importance of cervical cancer control in Japan.

The present study aimed to compare cancer incidence and trends in survival for children diagnosed in Japan and England, using population‐based cancer registry data. The analysis was based on 5192 children with cancer (age 0‐14 years) from 6 prefectural cancer registries in Japan and 21 295 children diagnosed in England during 1993‐2010. Differences in incidence rates between the 2 countries were measured with Poisson regression models. Overall survival was estimated using the Kaplan–Meier method. Incidence rates for Hodgkin lymphoma, renal tumors and Ewing sarcomas in England were more than twice as high as those in Japan. Incidence of germ cell tumors, hepatic tumors, neuroblastoma and acute myeloid leukemia (AML) was higher in Japan than in England. Incidence of all cancers combined decreased in Japan throughout the period 1993 to 2010, which was mainly explained by a decrease in registration of neuroblastoma in infants. For many cancers, 5‐year survival improved in both countries. The improvement in survival in chronic myeloid leukemia (CML) was particularly dramatic in both countries. However, 5‐year survival remained less than 80% in 2005‐2008 in both countries for AML, brain tumors, soft tissue sarcomas, malignant bone tumors and neuroblastoma (age 1‐14 years). There were significant differences in incidence of several cancers between countries, suggesting variation in genetic susceptibility and possibly environmental factors. The decrease in incidence for all cancers combined in Japan was related to the cessation of the national screening program for neuroblastoma. The large improvement in survival in CML coincided with the introduction of effective therapy (imatinib). For many of childhood cancers, 5‐year survival improved in Japan and England. The improvement in survival in chronic myeloid leukaemia (CML) was particularly dramatic in both countries.

Background: Research findings indicate that four health-related behaviors (HRBs), smoking, alcohol, diet, and physical activity, do not co-occur within individuals by chance and therefore cluster. To date, there is a lack of research investigating the clustering of these HRBs in the Japanese population.Methods: The Japanese National Health and Nutrition Survey 2010 was used, containing information on 8,015 community-dwelling adults. Latent profile analysis identified distinct cluster patterns of four HRBs: smoking status, alcohol consumption, calorie intake, and the number of steps per day.Results: For men, four distinct HRB clusters were identified. The largest cluster (54%) was characterized by drinking more than Japan’s recommended alcohol guidelines and walking an inadequate number of steps per day. A small cluster (4%) also emerged, characterized by smoking, high calorie intake, and exceeding alcohol guidelines. Members of these clusters had higher systolic blood pressure than those in the remaining clusters. For women, five distinct HRB clusters were identified. The largest cluster (57%) was characterized by not smoking or drinking and walking an inadequate number of steps per day. For both genders, there was a relationship between cluster membership and age. Cluster membership was associated with income and health status among men but not women.Conclusion: Detecting distinct clusters of HRBs in a Japanese population-based survey provides a person-centered understanding of Japanese lifestyles. This approach can assist policy makers in Japan and overseas to identify new strategies for targeting behavioral risk factors and make health promotion policies more effective in their respective countries.

Characterizing trends in mortality rates with consideration of trends in incidence rates at the population level could help identify unmet needs in public health and provide essential indicators of cancer control. In the late 20th century, the arrival of the first molecular targeted agent, rituximab, for non‐Hodgkin lymphoma (NHL) led to a paradigm shift in NHL treatment. However, the public health impact of this arrival has not been fully clarified. Here, we evaluated trends in the mortality and incidence rates of NHL in Japan and the United States. Age‐standardized rates of mortality reversed after the introduction of rituximab, around 2000, beginning to decline significantly with annual percent changes (95% confidence interval) of −2.6% (−3.6% to −1.6%) in Japan and − 3.9% (−4.2% to −3.5%) in the United States. Despite an increase in incidence, the mortality in all age groups weakened the upward trends or decreased in both countries. From a long‐term perspective, the trends in mortality rates differed between the countries. In the United States, the mortality rate has declined continuously since the introduction of rituximab, with a declining incidence rate. In contrast, in Japan, the mortality rate stopped declining and the incidence rate increased remarkably. The introduction of rituximab has had a substantial impact at the population level across a wide range of individuals. To reduce the disease burden in terms of mortality, elucidating risk factors that lead to a decreasing incidence rate is warranted for NHL, as well as further development of novel treatments.

Background During the coronavirus disease (COVID-19) pandemic, essential workers (e.g. medical workers) may be at a high prevalence of contracting COVID-19; however, the trend remains unclear in Japan. This study aimed to investigate occupational differences in the prevalence of COVID-19. Methods Data were retrieved from the 2022 Japan COVID-19 and Society Internet Survey. We analyzed the self-reported SARS-CoV-2 infection as of October 2022. We included 21,875 participants aged 20–64 years. Participants were classified into five occupation groups (“medical workers,” “off-site medical workers,” “care workers,” “other essential workers”, and “non-essential workers”), as well as those unemployed. The prevalence ratio of COVID-19 was computed using Poisson regression. We included sex, age, SARS-CoV-2 vaccination history, number of households, education level, and residential area as covariates. Additionally, we performed similar analyses for three time periods: (1) August–September 2022, (2) October 2021 to July 2022, and (3) before September 2021. Results The overall cumulative prevalence of COVID-19, as of October 2022, was 16.5%. Regarding occupation, medical workers had a higher prevalence than non-essential workers (23.5% vs 16.2% (difference: 7.2% point [95% confidence interval (CI): 4.2–10.2])). Similar results were observed among care workers compared with non-essential workers (22.1% vs 16.2% (difference: 5.9% point [95% CI: 2.5%–9.3%])). Other essential workers had a similar prevalence to non-essential workers (17.6% vs 16.2% (difference: 1.4% point [95% CI: -0.1%–2.8%]). In relative terms, medical workers and care workers were associated with an increased prevalence of COVID-19 (prevalence ratio: 1.44 [95% CI: 1.20–1.73] and 1.36 [95% CI: 1.11–1.66], respectively). In addition, we found that younger age, living in endemic region (e.g., Tokyo and Osaka), and living with more than four people contributed to the higher prevalence. According to the time period, the prevalence was significantly higher in medical and care workers than in non-essential workers only during August–September 2022, which corresponded to the severest outbreak period in Japan. Conclusions In Japan, medical and care workers had a higher prevalence of contracting COVID-19 compared to non-essential workers. However, this trend emerged during the peak of the COVID-19 spreading in the summer of 2022.

To examine the status of food expense insufficiency in Japan during the coronavirus disease 2019 (COVID-19) pandemic and the socioeconomic and sociodemographic factors associated with food expense insufficiency. Food expense insufficiency before and after the pandemic was assessed. The multivariable-adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated for the association between food expense insufficiency and socioeconomic and sociodemographic factors. A large-scale, cross-sectional online questionnaire survey. From August to September 2020, 25,482 participants aged 15-79 years completed the questionnaire (JACSIS 2020 study; Group 1). In October 2020, 917 single parents were surveyed for oversampling purposes. There were 179 single parents in Group 1 and a total of 1096 single parents in Group 2. Group 1 and Group 2 had 747 (2.9%) and 55 (5.0%) participants, respectively, who experienced food expense insufficiency for the first time after April 2020. Young age, part-time employment, being a single parent (in Group 1), and the number of people in the household (five or more in Group 1 and child/children alone in Group 2) were significantly associated with food expense insufficiency. As being a single parent was significantly associated with food expense insufficiency in Group 1 (AOR [95% CI] = 7.23 [5.40-9.68]), we further examined it in Group 2. Single parents who exhibited multiple factors (young age, part-time employment, living only with child/children) were likely to experience food expense insufficiency (15.3-15.8%). Triggered by the pandemic, a small percentage of individuals experienced food expense insufficiency. We identified that factors such as young age, part-time employment, and being a single parent were significantly associated with food expense insufficiency, and discovered that a multiplicity of these factors further increased the risk. Our findings suggest an urgent need to support individuals with a potentially high risk of food expense insufficiency.

ObjectiveThe COVID-19 pandemic led to an increase in mortality in most countries in 2020, deviating from prior decreasing trends. In Japan, however, mortality was suggested to decrease in 2020. This study investigated long-term mortality trends and cause-specific contributions, focusing on the period of the COVID-19 pandemic in Japan.DesignWe analysed Japanese age-standardised mortality rates (ASMRs) from 1995 to 2021 using vital statistics.Main outcome measuresThe cause-specific annual ASMR changes were calculated in comparison with the previous year over the abovementioned period.ResultsThere was a general downward trend in overall ASMR for both sexes until 2020 followed by a small increase in 2021. In men, the all-cause ASMR (per 100 000 persons) decreased from 1352.3 to 1328.8 in 2020 (−1.74% from 2019), and increased to 1356.3 in 2021 in men (+2.07% from 2020). In women, the all-cause ASMR decreased from 746.0 to 722.1 in 2020 (−3.20% from 2019), and increased to 737.9 (+2.19% from 2020) in 2021. ASMRs from malignant neoplasms, pneumonia, accidents and suicide (men only) continued to decrease during the COVID-19 pandemic while the trend of cardiovascular mortality increased in 2021. Analysis of ASMR changes revealed that COVID-19, senility, cardiovascular disease and ‘other causes not classified as major causes’ contributed to the all-cause mortality increase in 2021.ConclusionsIn Japan, the decreasing trend in overall mortality continued in 2020 despite the COVID-19 pandemic. However, approximately 2% mortality increase was observed in 2021, which was attributable to COVID-19, senility, cardiovascular disease and ‘other causes’. The year 2021 was a turning point of mortality trends in Japan, although continued monitoring is warranted.

People in Japan have the longest life expectancy at birth in the world. Here, we compile the best available evidence about population health in Japan to investigate what has made the Japanese people healthy in the past 50 years. The Japanese population achieved longevity in a fairly short time through a rapid reduction in mortality rates for communicable diseases from the 1950s to the early 1960s, followed by a large reduction in stroke mortality rates. Japan had moderate mortality rates for non-communicable diseases, with the exception of stroke, in the 1950s. The improvement in population health continued after the mid-1960s through the implementation of primary and secondary preventive community public health measures for adult mortality from non-communicable diseases and an increased use of advanced medical technologies through the universal insurance scheme. Reduction in health inequalities with improved average population health was partly attributable to equal educational opportunities and financial access to care. With the achievement of success during the health transition since World War 2, Japan now needs to tackle major health challenges that are emanating from a rapidly ageing population, causes that are not amenable to health technologies, and the effects of increasing social disparities to sustain the improvement in population health.

Cancer in children, adolescents, and young adults (AYAs) although rare, is the leading disease‐specific cause of death in Japan. This study aims to investigate cancer incidence and type of treatment hospital among children and AYAs in Japan. Cancer incidence data (2016–2018) for those aged 0–39 years were obtained from the Japanese population‐based National Cancer Registry. Cancer types were classified according to the 2017 update of the International Classification of Childhood Cancer (Third Edition), and AYA Site Recode 2020 Revision. Cases were also categorized into three groups: those treated at core hospitals for pediatric cancer treatment (pediatric cancer hospitals [PCHs]), those treated at designated cancer care hospitals, and those treated at nondesignated hospitals. The age‐standardized incidence rate was 166.6 (per million‐person years) for children (age 0–14 years) and 579.0 for AYAs (age 15–39 years) (including all cancers and benign or uncertain‐behavior central nervous system [CNS] tumors). The type of cancer varied with age: hematological malignancies, blastomas, and CNS tumors were common in children under 10 years, malignant bone tumors and soft tissue sarcomas were relatively common in teenagers, and in young adults over 20 years, carcinomas in thyroid, testis, gastrointestinal, female cervix, and breast were common. The proportion of cases treated at PCHs ranged from 20% to 30% for children, 10% or less for AYAs, and differed according to age group and cancer type. Based on this information, the optimal system of cancer care should be discussed. The type of cancer in children, adolescents, and young adults in Japan varies according to age: hematological malignancies, blastomas, and central nervous system tumors were common in children under 10 years, malignant bone tumors and soft tissue sarcomas were relatively common in teenagers, and in young adults over 20 years, carcinomas were common.