Abstract
Recently, there are growing interests in local municipalities’ work in cancer screening tests, as the importance of preventive care for cancer is widely shared. However, in spite of the high checkup rate target in the Cancer Control Act, some local bodies place upper limits on the number of participants. This means there might be interregional inequality in terms of the opportunity for checkups. The present paper is devoted to studying whether the individual cancer checkup system (ICCS), which is supposed to be effective for promoting checkups, really increases checkup rates. In addition, we investigate the relationship between the implementation of ICCS and the fiscal climates of local bodies, using 3-year panel data for municipalities in Japan. Two main results are presented. First, we find positive effects of ICCS on checkup rates in gastric, colorectal and lung cancer tests. Second, a low fiscal climates index (FCI) results in a low share of participants who make use of ICCS, indicating that the prevalence of ICCS is influenced by the fiscal standing of municipalities. In other words, it is likely that local bodies which suffer from stringent fiscal climates do not have the incentive to increase checkup rates because of an additional fiscal burden.
