[Objectives] The test was conducted by assessing antibody titer after vaccination for two purposes. One was to provide information to patients and health checkup participants. The other was epidemiological evaluation. The number of clinical case reports of prozone phenomenon is very limited, and it is worthwhile to alert the public to this phenomenon in antibody assays.

 [Subjects] Two cases of false low values due to the prozone phenomenon on examination during a health checkup visit.

 [Method] The research protocol was approved by the Ethics Committee of Kohsei Chuo General Hospital (approval number: 2022-01). Antibody titers were measured by measuring device cobas8000 (Roche Diagnostics K.K.) and measuring reagent ElecsysAnti-SARS-CoV-2S (300) RUO.

 [Results] In case 1, the range was 1x (157), but at 10x and 100x, it was over the range and the prozone phenomenon was observed. Case 2 was 1x (212), but the same phenomenon was observed at 10x, 100x, and 200x.

 [Conclusions] In case of low antibody titer, close examination by retesting seemed to be important.

 The majority of patients with pancreatic ductal adenocarcinoma (PDAC) which accounts for 90% of pancreatic cancer presents a poor prognosis due to advance stage with low resection rate. Since early-stage PDAC has prolonged survival rates, the goal remains early detection and accurate diagnosis. Pancreatic examination is recommended for individuals with risk factors for PDAC such as family history, smoking, heavy drinking, diabetes, obesity, chronic pancreatitis, intraductal papillary mucinous neoplasm (IPMN) and pancreatic cyst. Endoscopic ultrasonography (EUS) is useful for high detection rate of small pancreatic lesion due to its high resolution without artifact by gastrointestinal tract gas. MRI plus MRCP can estimate both pancreatic parenchyma and the pancreatic duct. Recently, focal pancreatic parenchymal atrophy or fatty change suggests specific findings of early PDAC. In cases of suspected malignancy, a histological evaluation such as EUS-guided tissue aquation (EUS-TA) or ERCP-guided pancreatic juice cytology plays an important role. Cystic neoplasm of the pancreas includes IPMN, mucinous cystic neoplasm (MCN), serous neoplasm (SN), and so on. IPMN has the potential for malignant transformation to PDAC. Combination of MRCP and EUS is assumed to be useful for pancreatic disease screening. Further large population study is necessary for establishment of its significance.

 Breast cancer screening in Japan has been uniformly performed, without considering individualization, with mammography which has scientific evidence of mortality reduction. However, mammography may not be an accurate modality for early detection of breast cancer in patients with dense breast, and ultrasound screening is being explored for younger women.

 In the era of genomic medicine, next-generation screening must be individualized and efficient based on the concept of precision medicine. The first is the efficient narrowing down of patients at high risk of developing breast cancer and the selection of the appropriate modality. The integrated analysis of big data from genetic information and electronic medical records may enable subgrouping of residents who are more susceptible to breast cancer, and this method is to continuously perform tests with high diagnostic performance on these groups. The second is the use of body fluids such as blood, tear fluid, and urine. The Aminoindex^®, which applies the balance of amino acid concentrations in the plasma of cancer patients compared to healthy individuals to screen for cancer risk, and N-NOSE^®, which uses the migration ability of the nematode C. elegans in response to odors emitted from the urine of cancer patients to determine cancer-bearing risk, are already in commercial use. Both are operated as prescreening to evaluate carcinogenic rates and risk of cancer development.

 Liquid biopsy, in which microRNAs of exosomes secreted by cancer cells are analyzed using blood or tear fluid, has been reported to have excellent sensitivity and specificity, and a large-scale clinical trial involving 3,000 patients has been initiated.

 Cancer screening using body fluids is expected to reduce the burden on both medical professionals and examinees because it is easy to perform, less invasive, and does not involve exposure to X-rays. We believe that verification of the accuracy of cancer screening using these methods should be promoted only for breast cancer, for which existing screening methods are well established.

 Breast cancer screening examinees are becoming more interested in dense breasts, and there are calls for notification of the "breast composition" including high-density breasts along with the screening results. In the United States, due to the rise of the "are you dense?^®" Movement, including Dr. Nancy, who is the party concerned, legislation, has been established in 38 states to require notification of breast composition. In Japan, in 2019, Okayama University conducted a multicenter study on Japanese women, and found that there is a strong relationship between high-density breasts and the risk of developing breast cancer in postmenopausal women and obese women. The breast cancer odds ratio for breast cancer is 2.85 times postmenopausal and 11.89 times for obese women .The FDA (US Food and Drug Administration) recommends that mammography-owning facilities should also report to patients and notify them of high-density breasts. The ACR (American Radiological Society) also needs to understand its own breast composition (mammary gland concentration) after undergoing a medical examination, and will work in cooperation with Congress, regulatory bodies, and patient groups on the premise that it is the examinee first. Expressed. On the other hand, in Japan, notification of breast composition is premature and not actively promoted. The examination is done at your own will to know your own health information. It is essential to get information about your body from the results of the examination. In order not to mislead the general public with misunderstandings and incorrect information about high-density breasts, it is possible for experts, the government, and patient groups to work together to promote notification of breast composition. It is indispensable for spreading lifestyle. In order for the next generation of Japanese breast cancer screening to move toward the world standard risk-based individualized screening, it is urgent to protect the right to know and enhance health literacy.

 [Objective] Under the declaration of a state of emergency due to the spread of Coronavirus Disease-2019 (COVID-19) in April 2020 and May 2020, we suspended the provision of general health examination. In June 2020, we resumed our service but restricted the number of examinees to 60% of the usual capacity. In this study, the backgrounds of examinees evaluated before and after these months were compared.

 [Methods] Among female examinees who received general health examination at our hospital between January 2019 and December 2020, we targeted a total of 3,494 cases in which the insureds' health insurance classifications were confirmed to be principal or dependent family members. We studied the number of breast and uterine cancer screenings performed and the number of cases of these cancers that were diagnosed.

 [Results] Compared with the 2019, we identified a decreased number of examinees in the 2020 who were between the ages of 35 and 39 years, regardless of the insureds' classifications. There were relatively more breast cancer screening applicants than during normal years in the principal member classification, but the number of applicants was approximately the same as that during normal years in the dependent family member classification.

 [Discussion] In many cases, general health examination examinees who are subsidized by health insurance in the principal member classification receive qualified periodical health examinations in accordance with the Industrial Safety and Health Act. However, women in their thirties and forties have vitally important roles in raising children, and they are also at an increased risk of developing breast and uterine cancers. Therefore, examination for early detection is essential. In the future, engaging in subtle awareness activities based on the examinees' backgrounds such as their lifestyles and work environment, providing needed information, and encouraging examinations are important.

 In the midst of the COVID-19 pandemic, we have undertaken several initiatives in addition to our usual infection control measures. One of the measures is the use of air catalysis for antiviral control in facilities, followed by the implementation of COVID-19 antibody tests for our staff over time, and participation in the vaccination project for COVID-19 in companies for which we provide medical checkups. Through the above efforts, we were able to help medical examinees undergo medical checkups with a peace of mind while also helping staff to take measures against infection, and accelerate the workplace vaccination project in Japan.