Objective: To clarify causal factors underlying the low cervical cancer screening rate in young women.
Methods: Six hundred thirty eight young women in their 20s and 30s who underwent uterine cervical cancer screening from April 2011 through March 2012 and 116 young women who received voluntary prophylactic vaccination for uterine cervical cancer from January 2010 through March 2014 were enrolled. We conducted a survey regarding their awareness of cancer check-ups using a question sheet.
Results: The reasons for not undergoing cervical cancer screening in 75.1% and 28.7% of the women in their 20-30s were “No reason, no opportunity” and “Unrelated to me”, respectively. The reason for undergoing screening in 69.4% of the women was “Was mailed coupon for cervical cancer screening”. These results indicate that the significance of cervical cancer screening needs to be explained more thoroughly and that the provision of opportunities promoted screening behavior. While 60.5% of the women considered the ideal interval for screening to be one year, just 16% had undergone it every year and another 16% every two years. On the other hand, 92.5% of the women who found out about and actually received prophylactic vaccination indicated a willingness to continue to receive screening in the future.
Conclusions: We predict that screening behavior in Japan will be raised to the international level by enhancing recognition of cervical cancer screening and encouraging screening behavior through the provision of screening opportunities based on the understanding that cervical cancer is preventable.

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Objective: We examined an association between longitudinal change in pulmonary function and smoking habit in health check-ups.
Methods: Our subjects were 4,178 individuals (2,969 males, 1,209 females) aged from their 30s to their 60s who underwent a health check-up at our health check-up center in both 2008 and 2013. We investigated associations between one-second forced expiratory volume (FEV₁), longitudinal change in FEV₁ and FEV₁%, and smoking habit, no smoking period and smoking amount.
Results: FEV₁ and FEV₁% were lower in male smokers and longitudinal decline in FEV₁ was significantly greater in smokers than in former smokers and non-smokers. Although no significant differences in FEV₁ and FEV₁% were observed for smokers in the 30s age group, there were significant declines in these parameters in smokers as compared to former smokers and non-smokers in the 40s, 50s and 60s age groups. Regarding subjects who were smokers in 2008, longitudinal declines in FEV₁ for those who continued smoking and those who quit smoking by 2013 were 34.4 mL/year and 23.6 mL/year, respectively, with the decline in continuing smokers being significant. As for FEV₁%, the difference between the former smokers and non-smokers disappeared after more than 5 years and FEV₁% was significantly higher than in the smokers group.
Conclusion: FEV₁ and FEV₁% decreased with smoking and there was a large decline in FEV₁ over time. However, in people in their 50s and 60s, the decline in pulmonary function can be reduced by stopping smoking.

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Objective: Individuals with impaired lung function tend to have an elevated risk of cardiovascular events but the nature of a relationship between impaired lung function and hypertension is poorly understood. We therefore analyzed a relationship between hypertension and lung function.
Methods: In order to assess a relationship between low lung function and development of hypertension, we retrospectively studied 2,643 non hypertensive males who had a health check-up in our health check-up division in 1997 and at least one more health check-up from 1998 to 2006. We assumed that those whose systolic pressure was over 140 mmHg, diastolic pressure was over 90 mmHg or who were taking a hypertensive drug had become hypertensive in the follow-up years. We analyzed which of 8 risk factors (age, BMI, high normal pressure, lipid disorders, diabetes, alcohol drinking, smoking, low lung function) in 1997 predicted the development of hypertension. Low lung function is determined from percentage forced expiratory volume in one second (%FEV₁). To analyze how the 8 risk factors affected the development of hypertension, we used univariate and multivariate logistic models.
Results: A total of 422 subjects became hypertensive during the observation period. Age, BMI, high normal pressure, lipid disorders, diabetes, smoking, and low lung function were significant factors in univariate analysis. Age, BMI, high normal pressure and low lung function were significant in multivariate analysis.
Conclusions: The findings of this study suggested that low lung function is a risk factor of hypertension.

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Objective: To examine differences in fundus photograph findings between metabolic syndrome (Mets) and non-Mets individuals.
Methods: Fundus photographs were examined for 2,189 men (average age: 48.3 ± 8.4yrs) and 728 women (47.4 ± 8.2yrs) who visited our health check-up division from May 6, 2011 to April 28, 2012.The images were diagnosed by ophthalmologists. We divided the examinees into two groups: Mets group and non-Mets group according to the Japanese diagnostic criteria of Mets, and examined the differences in fundus photograph findings between them. Statistical analysis was performed using the t test, the chi-square test, Fisher's exact test and the Cochran-Mantel-Haenszel test with p<0.05 regarded as significant.
Results: Among the total of 2,917 examinees, the number of Mets subjects was 408 and that of non-Mets subjects was 2,509. One hundred twenty eight (31.4%) of the 408 examinees in the Mets group and 489 (19.5%) of the 2,509 in the non-Mets group had abnormal findings in the fundus photographs. There was a significant relationship between Mets and abnormal findings, which included optic nerve cupping expansion, chorioretinal atrophy and diabetic retinopathy.
Conclusion: Mets examinees may have more ophthalmic disorders than non-Mets examinees.

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Objective: The aim of this study was to explore an association between fasting plasma glucose (FPG) and blood pressure in individuals with normal FPG levels.
Methods: Among those who were not taking antihypertensive, antihyperlipidemic, or antihyperuricemic agents, we retrospectively investigated 1,114 subjects with FPG < 100ml/dL and HbA1c < 5.6% in a general health check-up. Various parameters, including age, gender, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), uric acid (UA), estimated glomerular filtration rate (eGFR), smoking habit, alcohol intake, and familial history of hypertension and diabetes, were evaluated. On the basis of the FPG levels, the subjects were categorized into the following tertiles: T₁ (62 mg/dL ≤ FPG < 90 mg/dL, n = 398), T₂ (90 mg/dL ≤ FPG < 95 mg/dL, n = 356), and T₃ (95 mg/dL ≤ FPG < 100 mg/dL, n = 360).
Results: Univariate analysis on the total number of subjects revealed that age, gender, BMI, WC, TC, TG, LDL-C, UA, and FPG were positively correlated with SBP and DBP. On the other hand, HDL-C and eGFR were negatively correlated with SBP and DBP. Stepwise linear regression analysis showed that FPG was significantly and independently correlated with SBP and DBP. Furthermore, despite adjusting for confounding variables, the SBP and DBP levels of T₂ and T₃ subjects were significantly higher than those of T₁ subjects.
Conclusion: FPG levels were found to be a key determinant of blood pressure in subjects with normal FPG.

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Objective: Our aim was to clarify factors affecting the intention to use our Ningen Dock again through a questionnaire survey and to study measures that would help ensure repeat use.
Methods: We conducted a survey of 3,101 persons who underwent Ningen Dock at our health check-up center from August 13 2013 to March 31 2014 by having them fill out a questionnaire immediately afterwards. The subjects of this study were the 2,112 persons who responded (response rate 68.1%) and they were divided into 2 groups for statistical analysis - all subjects and subjects aged up to 64 (since response rate was high for up to 64).
Results: In the analyses of all subjects and subjects up to the age of 64, among those who were negative about repeat use of our Ningen Dock, few selected the responses of “good quality service, I felt at ease”, “technicians were good” and “short waiting times”.
Conclusion: To ensure repeat use of our health check-up center by customers, especially those up to the age of 64, it is very necessary to instruct staff to improve service with respect to waiting times, tests that are particularly painful or cause discomfort.

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Objective: With a view to raising the further examination rate in our facility, in April 2013 we began using an improved manual for nurses' support of actions by examinees requiring further medical examinations.
Methods: A basic point in the improvement of the manual was that that nurses spend more time on support. The subjects of this study were 589 examinees requiring further medical examinations from April 2012 to March 2014. We assessed the effectiveness of the new manual by investigating further examination rates.
Results: Further examination rates improved from 62.6% to 71.1% (8.5% up) for all check-up examinations and from 58.3% to 70.0% (11.7% up) for Ningen Dock.
Conclusion: We were able to confirm the important role of nurses' support of actions by examinees requiring further medical examinations.

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We present a case of thoracolithiasis, a rare thoracic disease. A 64-year-old female who underwent chest radiography and MDCT in mass screening at our hospital was found to have a round or oval calcified nodular opacity in the left posterior thoracic cavity at the 7th thoracic spine level. She had no symptoms. In reexamination of a chest CT image from 2 years ago，the calcified nodular opacity was observed in the left posterior thoracic cavity at the 11th thoracic spine level, not in the same position as in the latest image, so it had moved freely in the intrapleural cavity. Therefore, the nodular opacity was diagnosed as intrapleural loose body, so called thoracolithiasis. This chest CT study confirmed the mobility of thoracolithiasis, a rare condition.

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