Objective The number of people with diabetes in Japan has risen rapidly, which impose a heavy burden on both patients and society. It is therefore important to develop effective strategies for the prevention and management of type 2 diabetes based on individualized estimates of the trend of diabetes in the population. The aim of the present study was to survey the incidence of new-onset diabetes and identify the group of people who will require medical consultation due to hyperglycemia in the near future.

 Methods 5,603 men and 4,420 women diagnosed as non-diabetes in the first year and who underwent health checkups in the next year were enrolled. The clinical parameters among the three groups (non-diabetes, subjects under treatment for diabetes, subjects needing medical consultation due to hyperglycemia) were compared.

 Results The incidence of new-onset diabetes was 2.14%/year in men and 1.36%/year in women. It is considered a feature of our community that the majority of the subjects who newly developed diabetes were already on treatment at the second visit, probably during treatment for other lifestyle-related diseases. The subjects without treatment and those needing medical consultation due to hyperglycemia showed increased visceral obesity and exacerbation of glycemia.

 Conclusion In order to improve diabetes care in the community, it is important to understand the characteristics of subjects who will require medical consultation due to hyperglycemia in the near future and to encourage medical consultation by a doctor explaining the results on the day of the health checkup.

 Background: Higher fish consumption has been reported to be associated with a lower incidence of coronary artery disease (CAD). We hypothesized that higher fish intake may be associated with lower serum low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (L/H) ratios, an atherogenic marker, and healthier lifestyle behaviors.

 Methods: This cross-sectional study was conducted in 2,768 apparently healthy males receiving no lipid-modifying therapy and visiting the Health Planning Center of Nihon University Hospital between April and August 2019.

 Results: The average number of days of fish intake per week was 2.32 ± 1.31. The L/H ratio decreased significantly as the weekly frequency of fish intake (0-2 days, 3-4 days, or 5-7 days) increased (p < 0.0001). Multivariable regression analysis after adjustment for age, subject background factors, and cardio-metabolic risk revealed that increased weekly frequency of fish intake was a weak, but significantly independent determinant of a decreased L/H ratio (β = –0.064, p = 0.0008). Furthermore, as the frequency of fish intake per week increased, the proportion of subjects with cigarette smoking decreased (p = 0.003), the proportion of subjects engaging in habitual aerobic exercises increased (p < 0.0001), and the sleep duration and alcohol intake of the subjects increased (p < 0.0001).

 Conclusions: These results suggest that a high weekly frequency of fish intake was associated with lower L/H ratios, as well as healthier lifestyle behaviors; thus, it may represent a component of a healthy lifestyle associated with a lower risk of CAD in Japanese males.

 Iron deficiency anemia is reported to have malignant and non-malignant etiologies, including gastro-intestinal bleeding and uterine leiomyoma. Iron deficiency anemia has been associated with secondary thrombocytosis. Furthermore, iron deficiency anemia with thrombocytosis may lead to the development of fatal thrombotic disorders.

 Here, we report the case of a 45-year-old asymptomatic woman with severe anemia (Hb 5.9 g/dL) and thrombocytosis (461.0 × 10⁹/L) that was detected during a blood test performed as part of a routine health checkup. Based on the findings from the blood test, the patient was clinically diagnosed with iron deficiency anemia with thrombocytosis. Thereafter, computed tomography (CT) revealed uterine leiomyoma which causes chronic anemia. The iron deficiency anemia with thrombocytosis improved following treatment with an oral iron supplement. Furthermore, we discussed the literature review about iron deficiency anemia with thrombocytosis resulting in thrombotic disorders.

 Japan carries out more medical screenings than anywhere else in the world. This article will explain typical "cancer screenings" based on age groups.

 Examinations are a shorter version of "medical examinations" and have been explained as "confirmations of a person's health." The Committee specified that these were for the purpose of "not necessarily confirming the existence of disease, but rather understanding values over time from the perspective of promoting health, by giving health guidance and aiming to change behavior and reduce risks in accordance to risk levels identified for future disease based on these values."

 Screenings are a shorter way of saying "inspection and diagnosis", and have been explained as "performed for the purpose of discovering a specific disease." According to the Committee, these are "performed for the purpose of confirming the existence of disease. Therefore, when the result is "positive," a detailed inspection is performed and if the presence of the disease is diagnosed it is treated. When the result is negative, follow-ups are performed until the next screening." A typical example of these screenings is "cancer screenings." Cancer screenings are extremely important for the prevention and early detection of "cancer," the leading cause of death in Japanese people.

 Leukocytosis is reported to have malignant and non-malignant etiologies such as infectious diseases and smoking. However, it is important to rule out asymptomatic cases of hematological malignancy in the early stages based on leukocytosis findings on blood tests during health checkups. Here, we report a 52-year-old asymptomatic woman with leukocytosis (white blood cell count of 13.01 × 10⁹/L) that was incidentally detected on a blood test performed as part of a routine health checkup. According to the diagnostic criteria of the Japan Society of Ningen Dock, the examinee was referred to another regional hospital for further evaluation. Thereafter, based on findings from blood smears, bone marrow examination and major BCR/ABL polymerase chain reaction (PCR) examination, the patient was clinically diagnosed with chronic myeloid leukemia. Consequently, diagnosis during the early stages allowed successful treatment with a tyrosine kinase inhibitor, and the patient became disease-free.

 In conclusion, when we diagnose the leukocytosis on the blood test in health checkups, we should consult and refer to specialists to perform further detailed examinations and therapy in clinical practice.

 Objective: The purpose of this study was to determine the relationship between withdrawal time (WT) and quality indicators (Polyp Detection Rate (PDR), Adenomatous polyp Detection Rate (ADR), Mean number of Polyps found per Patient (MPP), and Mean Adenomatous polyp found per Patient (MAP)) in a screening colonoscopy for medical check-up.

 Methods: Endoscopic and pathological results were retrospectively reviewed for 840 colonoscopies performed by nine endoscopists at our facility between August and November 2018. ADR, PDR, MAP, and MPP were calculated and analyzed with WT at polyp identification (WT with polyp) or WT at polyp non-identification (WT without polyp).

 Results: The mean WT without polyp was 6.56 minutes, the mean WT with polyp was 13.6 minutes, ADR was 23.9%, PDR was 29.3%, MAP was 0.35, MPP was 0.43, and the rate of early cancer (T1a) detection was 0.32%. Correlation analysis revealed a high correlation between WT without polyp and ADR, PDR, MAP, and MPP (R²=0.88, 0.92, 0.88 and 0.92, respectively). Regression analysis with WT without polyp as explanatory variables found each index to be significantly predictive (ADR (P=0.0101), PDR (P=0.0005), MAP (P=0.0016), and MPP (P=0.0004)). Each index was found to be significantly improved when the cutoff value was 6.5 minutes of extraction time at polyp non-identification (ADR (35% vs 13.1%, P=0.0005), PDR (43% vs 15.7%, P=0.004), MAP (0.58 vs 0.17, P=0.006), and MPP (0.73 vs 0.2, P=0.001)).

 Conclusions: It was suggested that spending more than 6.5 minutes on whole colon observation may improve the rate of polyp detection.