The chief complaint of the examinees is few in medical checkup, diagnosis is largely due to clinical examinations. Especially since secondary prevention to primary prevention has been emphasized, inspection data guaranteed accuracy is indispensable for early detection of disease and determination of improvement effect. From now on, it will be expected that a system will be established regarding judgment of personal checkup results and guidance on improvement of life style from genetic testing and personal data accumulation.

 Clinical laboratory tests are broadly divided into specimen tests, physiological function tests, imaging tests, and endoscopies, a unique type of test. By performing the tests believed to be required, in combination with a patient interview and examination, a physician can diagnose diseases and pathologies, administer treatment, and monitor subsequent progress. Therefore, tests play a critical role in clinical healthcare. Tests constitute large portions of health checkups because these subjects include individuals without any symptoms. Therefore, these tests must be performed adequately to gain the patient's or subject's trust. Thus, high test precision and accuracy are required. These qualities are ensured through precision management, including internal and external quality control. Internal quality control involves daily management performed in a facility or laboratory, while external quality control involves cross-facility management, i.e., checking how the data of one's facility compares with those of other facilities. External quality control would be meaningless without internal quality control. This paper discusses internal and external quality control. Quality control has become commonplace in general widely-used sample tests, such as blood, urine, and stool tests; however, physiological function tests and imaging tests also require quality control. This is also true for bedside point-of-care testing (POCT); this paper also discusses its current status. Data focusing in sample testing is very good, owing to advancements in machines and reagents, however the internal quality control of daily laboratory tasks requires an attitude of constant attention to the data, without relying on machines. This paper will also elucidate the status of external quality control projects within this academic society and evaluate their importance. These days, there is a loud call for precision assurance in the laboratory, as in ISO15189 and the "Quality Control" in medical methods. We hope that this paper reveals more information regarding these topics.

 Objective Japan Health Promotion Foundation (JHPF) has been conducting the metabolic syndrome prevention screening since fiscal year 2008. The objective of this study is to compare the metabolic syndrome indicators (MSIs) between the 2008 and 2016 cross-sectional screening data.

 Subjects Subjects were 18,472 screening participants (14,285 men ages 46±10.97 years and 4,197 women ages 41.14±10.15 years) in fiscal year 2008 and 22,948 screening participants (17,846 men ages 45.98±12.06 years and 5,102 women ages 41.26±10.87 years) in fiscal year 2016 who were participants in the JHPF program sent from the Chamber of Commerce and large companies in major cities.

 Methods Comparisons between 2008 and 2016 were made on MSIs including waist measurements, systolic and diastolic blood pressure, total cholesterol, HDL-cholesterol, triglycerides, LDL-cholesterol, serum blood glucose, and HbA1c.

 Results Seven MSI averages in men and 6 MSI averages in women were lower in 2016 than in 2008. According to the waist size, 7 MSI averages with waist <85cm and 7 MSIs with waist ≥85cm among men were lower in 2016 than 2008, while 7 MSI averages with waist <90cm and 3 MSIs with waist ≥90cm among women were lower in 2016 than 2008.

 Conclusion It is considered that screening of MSIs is effective since most MSIs' averages were significantly decreased from 2008 to 2016.

 Objective: The aim of this study was to clarify the relationship between lifestyle modification and weight change in a longitudinal study over three years.

 Methods: The study subjects were 1,425 men with metabolic syndrome (MS) and pre-metabolic syndrome aged 40-59 years who received health checkups for MS in 2012 and 2015. We investigated the relationships between their lifestyle modification and weight change over three years in 2012-2015.

 Results: The groups who improved life habits for exercise, physical activity, nocturnal snack and meal in late night had a significant weight loss. On the other hand, the groups with deteriorated life habits for physical activity and nocturnal snack had a significant weight gain. Regarding the stage change of behavior modification and weight change, 247 men whose stage of behavior modification went up, significantly decreased their weight by 2.085 kg, but 168 men whose stage of behavior modification went down, significantly increased their weight by 0.982 kg.

 Conclusion: The relationships between lifestyle modification and weight change showed that it is important to support to keep healthy lifestyles as well as to encourage improvement of lifestyles.

 AIMS: We aimed to clarify the differences in both gender and age of upper gastrointestinal symptoms in health checkup subjects.

 METHODS: This study population includes 7,278 subjects who underwent upper endoscopy for health screening in a prospective, multicenter cohort study. Using a self-reporting questionnaire, we investigated the frequencies of upper abdominal symptoms, including heartburn and/or acid regurgitation for gastroesophageal reflux disease (GERD) symptoms, early satiation and/or bothersome postprandial fullness for postprandial distress syndrome (PDS) symptoms, and epigastric pain and/or epigastric burning for epigastric pain syndrome (EPS) symptoms. The differences in both gender and age of upper gastrointestinal symptoms were statistically evaluated by the chi-square test.

 RESULTS: The proportions of subjects who had GERD, PDS, and EPS symptoms at any frequency and the frequency of 1 day a week or more, were 37.4%, 28.4%, 21.2%, and 7.3%, 5.7%, 3.4%, respectively. The proportion of subjects who had any upper abdominal symptoms at any frequency and the frequency of 1 day a week or more were 48.9% and 10.8% respectively. GERD symptoms were more common in males, but the frequency decreased at age 60 and older. In females, the frequency of GERD increased with age and at over age 70 was higher than that in males. PDS and EPS symptoms were more common in females in all age groups, but the frequency in males decreased at age 60 and older, and the difference between the genders increased with age. Females were more likely to have symptoms overlapping with GERD, PDS, and EPS, whereas males were more likely to have only GERD symptoms.

 CONCLUSIONS: Approximately half of health checkup subjects had upper abdominal symptoms. Differences were observed in the pattern of upper abdominal symptoms depending on both gender and age.