2020 Volume 58 Issue 6 Pages 972-982
Japan's age-adjusted colorectal cancer mortality rate has decreased since 1996. However, in 2016, it was the highest among the G7 countries. Although colorectal cancer screening was initiated with the fecal immunochemical test (2 day method) in Japan in 1992, it has not shown significant results.
The issues regarding colorectal cancer screening in Japan are as follows: (1) the rate of undergoing close examination is only 68.5% according to the Report on Regional Public Health Services and Health Promotion Services (2016), and (2) the screening rate is as low as 41.4% according to the Comprehensive Survey of Living Conditions (2016). Meanwhile, in the UK, organized screening has been conducted for colorectal cancer screening using the fecal occult blood test. The screening rate was over 50% in 2015, and the rate of undergoing close examination exceeded 80%. Additionally, screening with sigmoidoscopy was initiated in England. In the US, total colonoscopy is conducted once every 10 years for colorectal cancer screening, with the screening rate exceeding 60% in 2015. Consequently, the age-adjusted mortality rate of colorectal cancer has steadily declined in the UK and the US and is currently lower than that in Japan.
To further reduce the mortality rate of colorectal cancer in Japan, the screening rate and the rate of undergoing close examination after colorectal cancer screening by the fecal immunochemical test should be increased by the recommendation of screening to the population, including to those in occupational fields. Additionally, screening colonoscopy should also be considered.
