Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
Current issue
Displaying 1-6 of 6 articles from this issue
Original Article
  • Keiko Murakami, Junko Ishihara, Ribeka Takachi, Shiori Sugawara, Misat ...
    2025 Volume 35 Issue 3 Pages 109-117
    Published: March 05, 2025
    Released on J-STAGE: March 05, 2025
    Advance online publication: August 03, 2024
    JOURNAL OPEN ACCESS
    Supplementary material

    Background: The Tohoku Medical Megabank Project (TMM) was established to realize personalized healthcare and medicine using genomic and omics data. This study evaluated the validity and reproducibility of food group intakes derived from a self-administered food frequency questionnaire (TMM-FFQ) that included the response option “constitutionally unable to eat/drink it” among community-dwelling Japanese adults.

    Methods: Participants comprised 89 men and 124 women aged ≥20 years from Miyagi Prefecture. Participants completed weighed food records (WFRs) for 3 consecutive days per season as reference intake and FFQs in 2019 (FFQ1) and 2021 (FFQ3). Spearman’s rank correlation coefficients (CCs) were calculated for correlations between food group intakes estimated from the 12-day WFR and FFQ3 (validity), and for correlations between those estimated from the FFQ1 and FFQ3 (reproducibility). Cross-classification according to quintiles using FFQ and WFR data was also performed.

    Results: The percentage of participants who chose the “constitutionally unable to eat/drink it” option was non-negligible for some food groups. In the validity analysis, CCs were >0.40 for many food groups; the median across 21 food groups was 0.49 in men and 0.45 in women. The median percentages of cross-classification into exact plus adjacent quintiles were 73.0% in men and 66.9% in women. In the reproducibility analysis, CCs were >0.50 for many food groups; the median across 21 food groups was 0.60 in men and 0.51 in women.

    Conclusion: The validity of the TMM-FFQ compared with 12-day WFR and the reproducibility of the TMM-FFQ were reasonable for food groups in the TMM cohort studies.

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  • Takeshi Makiuchi, Masako Kakizaki, Tomotaka Sobue, Tetsuhisa Kitamura, ...
    2025 Volume 35 Issue 3 Pages 118-128
    Published: March 05, 2025
    Released on J-STAGE: March 05, 2025
    Advance online publication: August 24, 2024
    JOURNAL OPEN ACCESS
    Supplementary material

    Background: The health statuses of closely connected individuals are interdependent. Little is known about mortality risk associated with partner’s cancer diagnosis and cause-specific mortality risk associated with partner’s death.

    Methods: Relative risks for all-cause and cause-specific mortality following a partner’s cancer diagnosis or death compared to the period when the partner is cancer-free and alive were investigated in the population-based prospective cohort study that enrolled 140,420 people at the age between 40–69 years in 1990–1994.

    Results: 55,050 participants (27,665 men and 27,385 women) who were identified as married couples were followed-up for 1,073,746.1 (518,368.5 in men and 555,377.6 in women) person-years, during which 9,816 deaths were observed (7,217 in men and 2,599 in women). After a partner’s cancer diagnosis, the mortality rate ratio (MRR) of all-cause mortality was not increased among both men and women, while an increase of externally-caused MRR was observed. The suicide MRR significantly increased among men (MRR 2.90; 95% confidence interval, 1.70–4.93), and it persisted for more than 5 years. After a partner’s death, the MRRs of all-cause, cardiovascular disease (CVD), respiratory disease (RD), and externally-caused mortality significantly increased only among men. Stratified analysis by smoking status among men showed significantly increased MRRs of CVD and RD mortality among former/current smokers, but not among never-smokers.

    Conclusion: Partner’s cancer diagnosis did not increase all-cause mortality risk, but increased externally-caused mortality risk, especially suicide among men. The impact of partner’s death on mortality risk differed by the mortality causes and sex, and smoking affected some of cause-specific mortality risk.

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  • Md. Mahfuzur Rahman, Md. Shafiur Rahman, Md. Rashedul Islam, Stuart Gi ...
    2025 Volume 35 Issue 3 Pages 129-140
    Published: March 05, 2025
    Released on J-STAGE: March 05, 2025
    Advance online publication: September 07, 2024
    JOURNAL OPEN ACCESS
    Supplementary material

    Background: The burden of cancer in India has been rising, yet testing for early detection remains low. This study explored inequalities in the uptake of breast cancer (BC) examination and cervical cancer (CC) among Indian women, focusing on socioeconomic, regional, and educational differences.

    Methods: Data from the 2019–21 National Family Health Survey (n = 353,518) were used to assess the uptake of BC examination and CC testing. Inequalities were quantified using the slope index of inequality (SII), relative index of inequality (RII), and relative concentration index (RCI). SII measured absolute inequality, while RII and RCI assessed relative inequality between disadvantaged and advantaged groups.

    Results: The ever uptake of tests for early detection of BC and CC were low at 9 and 20 per 1,000 women, respectively. Higher uptake was observed among women from the richest households compared to the poorest (SII: 1.1 for BC and 1.8 for CC). The magnitude of relative socioeconomic inequalities was more pronounced in rural areas (RCI: 22.5 for BC and 21.3 for CC) compared to urban areas. Similarly, higher-educated women were 4.84 times (RII: 4.84) and 2.12 times (RII: 2.12) more likely to undergo BC examination and CC testing, respectively, compared to non-educated women. The Northeastern region exhibited greater socioeconomic inequality, while the Western region showed more education-based inequality.

    Conclusion: The lower uptake of BC examination and CC testing and the marked inequalities underscore the need for targeted interventions to improve access and utilization of testing services, especially among lower-educated women, and those in rural areas.

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Short Communication
  • Chi-Shin Wu, Le-Yin Hsu, Chen-Yang Shen, Wei J. Chen, Shi-Heng Wang
    2025 Volume 35 Issue 3 Pages 141-146
    Published: March 05, 2025
    Released on J-STAGE: March 05, 2025
    Advance online publication: July 20, 2024
    JOURNAL OPEN ACCESS
    Supplementary material

    Background: This study aimed to validate self-reported medical conditions in the Taiwan Biobank (TWBB), in which participants were inquired about 30 disease conditions, by comparing them with claims records from Taiwan’s National Health Insurance (NHI) claims database.

    Methods: We identified 30 clinical diagnoses using International Classification of Diseases - Clinical Modification codes from ambulatory and hospital claims within the NHI claims database, matching diseases included in the TWBB. The concordance between self-reports and claims records was evaluated using tetrachoric correlation to assess the correlation between binary variables.

    Results: A total of 131,834 participants aged 30–70 years with data from the TWBB and NHI records were included. Concordance analysis revealed tetrachoric correlations ranged from 0.420 (chronic obstructive pulmonary disease) to 0.970 (multiple sclerosis). However, several disorders exhibited lower tetrachoric correlations. The concordance was higher among those with higher education attainment, and lower among married individuals.

    Conclusion: The concordance between self-reports in the TWBB and NHI claims records varied across clinical diagnoses, showing inconsistencies depending on participant characteristics. These findings underscore the need for further investigation, especially when these variables are crucial to research objectives. Integrating complementary databases, such as clinical diagnoses, prescription records, and medical procedures, can enhance accuracy through customized algorithms based on disease categories and participant characteristics and optimize sensitivity or positive predictive values to align with specific research objectives.

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Statistical Data
  • Yasufumi Gon, Ling Zha, Toshitaka Morishima, Yasuyoshi Kimura, Kanako ...
    2025 Volume 35 Issue 3 Pages 147-153
    Published: March 05, 2025
    Released on J-STAGE: March 05, 2025
    Advance online publication: August 24, 2024
    JOURNAL OPEN ACCESS
    Supplementary material

    Background: Advancements in cancer care have improved survivorship, potentially leading to changes in mortality causes. This study aimed to investigate the causes of death among cancer survivors, specially focusing on non-cancer-related mortality.

    Methods: This nationwide population-based cohort study analyzed the causes of death based on the time since cancer diagnosis using data from the National Cancer Registry in Japan between January 2016 and December 2019. Non-cancer-related deaths were identified, and mortality risks associated with non-cancer diseases were compared to those of the Japanese general population using standardized mortality ratios (SMRs) with 95% confidence intervals (CIs). The follow-up period was up to 4 years after cancer diagnosis.

    Results: A total of 3,990,661 patients (45.8% women) were included in the analysis, yielding 6,237,269 person-years of follow-up. Of these, 1,001,857 (25.1%) patients died during the study period. Cancer-related and non-cancer-related causes accounted for 86.6% and 13.4% of deaths, respectively. The proportion of non-cancer-related deaths increased from 10.2% at 6 months to 31.6% at 4 years after cancer diagnosis. Heart disease (21.8%), cerebrovascular disease (9.8%), and pneumonia (9.1%) were the leading cause of non-cancer-related deaths: the SMRs for these diseases were 2.69 (95% CI, 2.66–2.72), 2.07 (95% CI, 2.03–2.10), and 2.41 (95% CI, 2.36–2.45), respectively. The SMR for suicide was 1.81 (95% CI, 1.74–1.89); however, it lost significance in males and females 2 and 2.5 years after cancer diagnosis, respectively.

    Conclusion: The proportion of non-cancer-related deaths among cancer patients has increased over time, emphasizing the need to manage cancer and its comorbidities carefully.

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  • Hirokazu Tanaka, Shuhei Nomura, Kota Katanoda
    2025 Volume 35 Issue 3 Pages 154-159
    Published: March 05, 2025
    Released on J-STAGE: March 05, 2025
    Advance online publication: October 26, 2024
    JOURNAL OPEN ACCESS
    Supplementary material

    Background: Amidst the global coronavirus disease 2019 (COVID-19) pandemic, Japan has faced a significant public health challenge, evident from the significant increase in mortality rates since 2021. This study described the variations in all-cause and cause-specific changes in mortality up to 2022 in Japan.

    Methods: This study used official Vital Statistics from the Ministry of Health, Labour and Welfare (MHLW) to assess the impact of the pandemic on mortality trends. An analysis of all-cause and cause-specific age-standardized mortality rates (ASMRs) from 1995 to 2022 was conducted, employing the 2015 Japan Standard Population. Sex- and cause-specific ASMRs for a particular year were compared with those from the preceding year to assess annual changes.

    Results: Among men, the annual all-cause ASMR per 100,000 people increased from 1,356.3 in 2021 to 1,437.8 in 2022 (6.0% increase). Among women, the annual all-cause ASMR increased from 722.1 in 2021 to 785.8 in 2022 (6.5% increase). Compared with the period 2020 to 2021, COVID-19 (+29.1 per 100,000 people for men and +13.4 per 100,000 people for women), senility (+14.1 per 100,000 people for men and +12.5 per 100,000 people for women), heart disease, malignant neoplasms (for women) and “other causes not classified as major causes” substantially contributed to the increase in all-cause ASMR from 2021 to 2022.

    Conclusion: Further long-term monitoring from 2023 onwards is necessary, especially for conditions like senility, cardiovascular disease, and cancer, which may have long-term effects due to changes in healthcare settings, even though the strong countermeasures against COVID-19 were lifted in 2023.

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