Objective:

 We aimed to determine whether the use of an information and communication technology (ICT)-based tool for monitoring post-screening health and lifestyle habits encouraged individuals to undergo regular screening and improve their own health.

Methods:

 The study targeted 43,043 individuals who underwent a health screening in the fiscal year 2013. The participants were grouped into either "user group" or "non-user group" depending on whether or not they used a health and lifestyle habit monitoring tool. The study also estimated the propensity score of the probability that participants registered their use of a monitoring tool. Linear regression and subgroup analyses were performed by the number of use times of this tool in a year.

Results:

 Evaluation of the association between monitoring tool use/non-use and repeated participation in screening during the next year showed a significantly higher level of repeated participation in the user group than in the non-user group. After the propensity score-adjusted, the user group was also significantly higher than that of the non-user group for both men (81.9% vs. 72.5%) and women (77.7% vs. 70.0%). The results of subgroup analysis in men indicated a propensity towards significantly lower BMI and waist circumference in participants who had a higher number of logins.

Conclusions:

 These findings suggest that self-monitoring using a health and lifestyle habit monitoring tool after health screening leads to a higher rate of participation in screening the following year and improvement in screening results, especially in men. This outcome was attributed to greater health awareness and motivation to undergo screening the following year based on the individual's recognition of his/her screening results and awareness of lifestyle habits.

 [AIM] Medical knowledge in medical checkup examinees or cancer patients was evaluated, and we clarified their influences on dietary and exercise habits or cancer progression.

 [Methods and Patients] The subjects in Study 1 were 73 medical checkup examinees, and those in Study 2 were 14 early or 18 advanced cancer patients. They have taken examinations about basic knowledge of medicine (about diseases), health insurance, and medical expenses, and then total points were calculated in each subject. In study 1, dietary and exercise habits were provided by interview sheets in each examinee. Good dietary habits are, for example, eating slowly, regularly, or much vegetable, on the contrary, bad dietary habits are skipping breakfast, eating big, salty or sweet foods. Good exercise habits were defined as taking exercise more than 2 times a week. In study 2, the relationships between total points and cancer progression were clarified.

 [Results] There were no significant differences in backgrounds of all studies. Good grade-examinees had better dietary and exercise habits than poor grade-examinees (Study 1). Patients with early cancer had significantly higher points than those with advanced cancer in all fields of examination (Study 2).

 [Discussion] It is important for examinees and patients to have medical knowledges, and it may cause all of us to have better prognosis.

 It has recently been reported that a chronic obstructive pulmonary disease (COPD) questionnaire is effective for identifying patients with air-flow limitations during general health examinations. Therefore, we used the International Primary Care Airways Group (IPAG)-COPD questionnaire to survey smokers aged ≧40 years during workplace health examinations at the Lion Corporation head office between April 2018 and December 2019. We investigated COPD diagnosis rates from the COPD questionnaire and smoking behavior modification. Air-flow limitation was defined as forced-expiratory volume in 1 second (FEV₁)/forced vital capacity (FVC) <70%. Among the 171 respondents, IPAG score ≧17 (abnormal) were detected in 36.3% (n=62), and air-flow limitations were identified using spirometry in 36 (58.1%) of them. The results showed that 22.2% (n=8) of these 36 employees had hitherto unidentified COPD. The questionnaire data revealed that 36.1% (n=13) of the 36 employees who underwent spirometry had undergone behavior modification to quit smoking.

 Screening for COPD using a questionnaire during workplace health examinations is more practical than spirometry and could identify many patients with COPD. We recommend applying a COPD questionnaire during more workplace health examinations as part of smoking-cessation measures to increase rates of detecting COPD. The questionnaire could be useful to preventing COPD and aggressive educational activities about COPD should be implemented as occupational health measures.

 [Backgrounds and Aims] Metabolic syndrome (MetS) is a condition in which visceral fat-type obesity with hypertension, hyperglycemia and dislipidemia, and is well known to risks for arteriosclerotic diseases. This concept is derived, Inherited from the conventional Syndrome X and Multiple Risk Factor Syndrome, however, an interest in tests other than diagnostic items is low and few reports have been made. The purpose of this study was to examine the effects of MetS on other than diagnostic items and obtain tips for health guidance, from the view point of multiple risk factor syndrome of the MetS.

 [Subjects and Methods] The subjects were conducted 4,830 males (50 ± 6.8 years old) and 4,328 females (50 ± 6.5 years old) to whom visited the Sendai General Health Examination Clinic (Shinkokai Medical Corporation SENDAI MEDICAL CLINIC) in 2016. According to the Mets criteria, groups were divided by the combination of diagnostic items, such as abdominal circumference (AC), hyperglycemia, dislipidemia, hypertension, as discribed below. 1) MetS non-applicable (AC not applicable), (2) MetS non-applicable (only AC applicable), (3) AC+hyperglycemia, (4) AC+dislipidemia, (5) AC+hypertension, (6) AC+hyperglycemia+dislipidemia, (7) AC+hyperglycemia+hypertension, (8) AC+dislipidemia+hypertension, (9) AC+hyperglycemia+dislipidemia+hypertension. Gender specific comparison study was made in age, AST, ALT, γ-GT, UA, Cr, TP, Alb in 9 groups.

 [Results] As a result of analysis of variance, both men and women showed significant differences in age, AST, ALT, γ-GT, and UA. AST, ALT, and γ-GT showed higher values for lipids in MetS diagnosis items. UA tended to show a high value accoding to numbers of applicable items. Cr was significantly increased only in males, and tended to be higher when lipid and blood pressure were applicable. ALT and UA showed high values for both men and women in not Mets but only AC applicable group.

 [Summary] Not only in the MetS and Pre-MetS groups, but also in the case where only the AC exceeded the standard, the organ functions such as liver and kidney tended to be worsened. The analysis results of MetS showed that it is necessary to focus on characteristic changes in multiple risk factor syndrome, instead of focusing only on diagnostic results, and to provide guidance.

 The Ministry of Health, Labor and Welfare, presented the necessary conditions for blood pressure (BP) measurement in medical examination institutions in April 2019. They are as follows; to set a minimum of 5 minutes resting time in a sitting position, to avoid exercise, food, smoking and conversation, to measure at least twice with at least a one minute interval between measurements, and to add further measurements if the difference between the measurements was greater than 5mmHg. To meet these conditions is not easy in medical examination institutions which examine many people in a short period of time.

 To clarify the present situation, we sent questionnaires to 48 medical examination institutions and received answers from 32. Resting time was set in 10 (31.3%) centers. However the length of resting time was not set in half the centers. Measurements were made by medical staff in all the institutions, mostly by only a nurse (71.9%). Self-measurement by the patient was not done. Only in 6 (18.8%) centers were two measurements done routinely. In 22 (68.8%) institutions, a second measurement was taken only when the first value was high. In only 10 (31.3%) institutions were average values used as BP value. In 11 (34.4%) institutions, the lower value was used. Among the 32 institutions, in which second measurements were taken, the interval between measurements was set in 23 (71.9%). The length of the interval was one to two minutes in 2 (8.7%), and not determined in 19 (82.6%) institutions. Conversation during the measurement was prohibited in 28 (87.5%) centers. Deep breathing, which decreases BP was recommended in 24 (75.0%) institutions. To meet the necessary conditions was very difficult in most of the medical examination institutions.