2025 Volume 63 Issue 6 Pages 981-990
The fecal immunochemical test (FIT) has been scientifically proven to reduce colorectal cancer (CRC) mortality. Since its benefits outweigh its harms, it is recommended for both population-based and opportunistic screening. In Japan, population-based CRC screening using FIT was initiated in 1992, and a subsequent decrease in age-adjusted CRC mortality rates has been demonstrated since the latter half of the 1990s. However, compared to other countries that also use FIT to screen for CRC, the decrease in mortality observed in Japan is insufficient.
According to the Comprehensive Survey of Living Conditions, a high proportion (49.1%) of individuals aged 40-69 reported undergoing CRC screening at their workplaces. Workplace-based CRC screening, categorized as non-statutory health check-ups, are implemented by employers and health insurers for employee welfare. There is currently no established system to continuously monitor the actual status of workplace-based screenings. Furthermore, methods and procedures that diverge from existing guidelines are often observed.
Therefore, to enhance the effectiveness and minimize the harms of FIT screening, it is crucial to implement organized screening, including those in workplace-based screening. Regardless of the form of screening implementation, a screening program capable of comprehensively capturing individual-level participation and ensuring quality control is warranted.
