Background: In Japan, few studies have examined suicide risk for 5-year relative survival rates for cancer sites. Since 5-year relative survival rates differ by sex, we aim to examine suicide risk for patients with cancer separately for men and women.

Methods: We estimated the risk of suicide among patients with cancer by sex in Japan compared to the general population, using standardized mortality ratios (SMRs). Patients with cancer diagnosed between January 1, 1985–December 31, 2013 and registered in the Osaka Cancer Registry were followed for up to 10 years. The outcome was suicide death. In addition, cancer sites were classified into three prognosis groups based on 5-year relative survival rates: good (>70%), moderate (40–70%), poor (<40%).

Results: Among 623,995 patients with cancer observed for 2,349,432 person-years, 1,210 patients died by suicide (867 men and 343 women). The SMRs were almost equal for men (1.66; 95% confidence interval [CI], 1.55–1.77) and women (1.65; 95% CI, 1.48–1.83). SMRs for cancer prognosis groups were 1.01 (95% CI, 0.84–1.22) for men and 1.47 (95% CI, 1.24–1.73) for women in the good group, 1.53 (95% CI, 1.39–1.68) for men and 1.74 (95% CI, 1.47–2.05) for women in the moderate group, and 2.54 (95% CI, 2.27–2.85) for men and 1.87 (95% CI, 1.43–2.46) for women in the poor group.

Conclusion: In this population, both sexes had higher suicide risk with poor prognosis, but the difference in SMRs between the good and poor groups was smaller for women than men.

Background: Despite the high frequency of tinnitus and its impact on wellbeing, little is known about its economic burden, and, to our knowledge, no data are available on out-of-pocket (OOP) expenses.

Methods: In 2022, a survey was conducted on OOP costs of tinnitus. We enrolled 679 participants with slight, moderate, and severe tinnitus in Italy, United Kingdom, Netherlands, Germany, and Spain. We estimated annual OOP expenses for tinnitus-related healthcare visits, treatments, medications, and alternative medicine practices. Prevalence of tinnitus in the general population, obtained from a representative survey we conducted in Europe in 2017–2018, was used to generalize costs for people with any tinnitus at the national level.

Results: OOP expenses were 368€ (95% confidence intervals [CI], 78€–690€), 728€ (95% CI, 316€–1,288€), and 1,492€ (95% CI, 760€–2,688€) for slight, moderate, and severe tinnitus, respectively, with annual expenditure of 565€ for people with any tinnitus: 209€ for healthcare visits; 93€ for treatments; 16€ for drugs; 64€ for hearing supporting systems; and 183€ for acupuncture, homeopathy, and osteopathy. Individuals with slight, moderate, and severe tinnitus expressed a willingness to invest 1.6, 4.3, and 7.0 times their monthly income, respectively, to achieve complete relief from tinnitus.

Conclusion: This study offers for the first time insights into the OOP expenses incurred by individuals with tinnitus. OOP expenses exhibited substantial variations based on severity status, accounting for more than 17 billion € in the countries considered. In terms of financial burden, these findings align tinnitus to the recognized leading disabilities, including back pain and migraine.

Background: Genetic epidemiological evidence for the kidney function traits in East Asian populations, including Japanese, remain still relatively unclarified. Especially, the number of genome-wide association studies (GWASs) for kidney traits reported still remains limited, and the sample size of each independent study is relatively small. Given the genetic variability between ancestries/ethnicities, implementation of GWAS with sufficiently large sample sizes in specific population of Japanese is considered meaningful.

Methods: We conducted the GWAS meta-analyses of kidney traits by leveraging the GWAS summary data of the representative large genome cohort studies with about 200,000 Japanese participants (n = 202,406 for estimated glomerular filtration rate [eGFR] and n = 200,845 for serum creatinine [SCr]).

Results: In the present GWAS meta-analysis, we identified 110 loci with 169 variants significantly associated with eGFR (on chromosomes 1–13 and 15–22; P < 5 × 10⁻⁸), whereas we also identified 112 loci with 176 variants significantly associated with SCr (on chromosomes 1–22; P < 5 × 10⁻⁸), of which one locus (more than 1 Mb distant from known loci) with one variant (CD36 rs146148222 on chromosome 7) for SCr was considered as the truly novel finding.

Conclusion: The present GWAS meta-analysis of the largest genome cohort studies in Japanese subjects provided some original genomic loci associated with kidney function, which may contribute to the possible development of personalized prevention of kidney diseases based on genomic information in the near future.

Background: There has been growing concern about the negative mental health impact of long working hours and overwork. Our study examined how work-life imbalance (WLI) could be a mediator between working hours and poor mental well-being.

Methods: We included 34,968 individuals from a nationwide cross-sectional survey in Korea. Self-reported working hours per week were collected, and mental health was assessed using the World Health Organization (WHO)-5 Well-Being Index. Counterfactual-based mediation models were employed to disentangle the total effects into a direct effect (work hour – poor mental health) and an indirect effect (work hour – WLI – poor mental health).

Results: Out of 34,968 participants, 52.6% worked 35–40 hours/week, 20.0% worked 41–48 hours/week, 11.7% worked 49–54 hours/week, and 15.6% worked ≥55 hours/week. The odds ratios (ORs) of the total impact of working hours on poor mental health were 1.08 (95% confidence interval [CI], 1.01–1.16) for 41–48 hours/week, 1.28 (95% CI, 1.17–1.39) for 49–54 hours/week, and 1.60 (95% CI, 1.48–1.74) for ≥55 hours/week in comparison to 35–40 hours/week. The ORs of the indirect effects were 1.04 (95% CI, 1.03–1.05) for 41–48 hours/week, 1.08 (95% CI, 1.07–1.09) for 49–54 hours/week, and 1.14 (95% CI, 1.12–1.16) for ≥55 hours/week, accounting for 51%, 31%, and 28% of the total effects, respectively.

Conclusion: Our findings suggest that WLI can partially mediate the association of long working hours with mental health deterioration. Policy efforts are required to mitigate the adverse mental health effects of overwork.

Background: Behavioral and psychological symptoms of dementia (BPSD) are common among people with dementia from the early stages and can appear even in mild cognitive impairment (MCI). However, the prognostic impact of BPSD is unclear. This study examined the association between BPSD and mortality among people with cognitive impairment.

Methods: This longitudinal study involved 1,065 males and 1,681 females (mean age: 77.1 years for males and 78.6 years for females) with MCI or dementia diagnosis from the National Center for Geriatrics and Gerontology-Life Stories of People with Dementia (NCGG-STORIES), a single-center memory clinic-based cohort study in Japan that registered first-time outpatients from 2010–2018. Information about death was collected through a mail survey returned by participants or their close relatives, with an up to 8-year follow-up. BPSD was assessed using the Dementia Behavior Disturbance Scale (DBD) at baseline.

Results: During the follow-up period, 229 (28.1%) male and 254 (15.1%) female deaths occurred. Cox proportional hazards regression analysis showed that higher DBD scores were significantly associated with increased mortality risk among males, but not females (compared with the lowest quartile score group, hazard ratios for the highest quartile score group were 1.59; 95% confidence interval, [CI] 1.11–2.29 for males and 1.06; 95% CI, 0.66–1.70 for females). Among the DBD items, lack of interest in daily living, excessive daytime sleep, and refusal to receive care had a higher mortality risk.

Conclusion: The findings suggest a potential association between BPSD and poor prognosis among males with cognitive impairment.

Background: The influence of the coronavirus disease 2019 (COVID-19) pandemic on dental care utilization may have differed according to individual characteristics or type of dental care provision. This study aimed to evaluate the changes in dental care utilization and per-attendance costs by age group and type of dental care during the COVID-19 pandemic in Japan.

Methods: This time-series study used healthcare insurance claims data from 01/07/2019 to 09/27/2021 (143 weeks) from nine municipalities in Japan. Dental care utilization rate per week and average dental care cost per attendance by age groups (0–19 years/20–64 years/65–74 years/≥75 years) and types of dental care (outpatient/visiting) were used as outcome variables. COVID-19 pandemic waves in Japan were used as predictors: 1^st (03/23/2020–05/17/2020), 2^nd (06/22/2020–09/27/2020), 3^rd (10/26/2020–02/21/2021), 4^th (02/22/2021–06/07/2021), and 5^th (07/05/2021–09/13/2021) waves. Fixed-effects models were employed to estimate the proportional changes.

Results: In the fixed-effects model, we observed large declines in dental care utilization during the 1^st (17.0–22.0%) and 2^nd waves (3.0–13.0%) compared to the non-pandemic wave period in all age groups. In contrast, the average dental care cost per attendance increased in all age groups by 5.2–8.6% during the 1^st wave.

Conclusion: During the initial wave of the COVID-19 pandemic in Japan, dental care utilization decreased in all age groups, whereas the average dental care cost per attendance increased. The COVID-19 pandemic may have changed the dental care provision pattern towards less frequent and more concentrated dental care to avoid the risk of infection.