Objective: Lifestyle disorders are chronic diseases that require long-term primary prevention measures. In the short term, changes in health checkup results are often small and subjective symptoms are rare, making it difficult to create an opportunity to engage in primary prevention. If the risk estimation score of lifestyle disorders (hereinafter referred to as "JPM score") can be reported to examinees immediately at the time of health checkups in a simple and cost-effective way, the same can be used for specific health guidance and other purposes.

 Methods: In this study, 51,771 people who underwent health examination in 2011 and 2021 were included in the creation of the "JPM score" prediction formula. The prediction formulae were generated by a logistic regression model (LRM). Machine learning models (MLMs) were used for performance comparisons.

 Results: The 3-year averages of accuracy score, area under the curve, and Matthews correlation coefficient for LRM were 77.2%, 0.823, 0.407, respectively, and for MLMs were 77.2–78.4%, 0.796–0.842, 0.406–0.451, respectively.

 Conclusions: No major differences were observed among models. LRM, which is computationally less expensive and easier to provide a basis for generating advisory comments, can be used to implement the "JPM score" in our core healthcare system.

 By conducting electrocardiography in medical checkups, various information such as arrhythmia, myocardial abnormalities, and the possibility of myocardial ischemia can be obtained, leading to early detection and treatment of heart diseases, which is highly significant. On the other hand, the electrocardiogram reflects the electrical phenomena of the heart, and the cases in which the name of the disease can be diagnosed based on this information alone are limited. The presence or absence of coronary risk factors and findings on chest x-ray may be important in making a decision. In addition, there are often cases in which diagnosis is difficult without observing changes over time in electrocardiograms without information on clinical symptoms and their progress. Therefore, in ECG judgment, it is desirable to make a judgment after taking into account information from medical interviews, examinations, and examinations other than ECG waveforms in addition to interpretation of ECG waveforms, and final confirmation by a specialist is essential.

 Under these circumstances, in order to maintain the trust of general health checkup participants, the facility is required to ensure that the electrocardiograms performed are of a level that is reliable. For that reason, it is important to confirm the level of the own facility by participating in external quality control as well as internal quality control. However, there are also differences in the circumstances of each facility, such as who performs the electrocardiogram evaluation at what timing for him, and how the evaluation results are reflected in the health checkup results. In this paper, I would like to describe the problems and issues surrounding electrocardiogram accuracy control.

 In addition, the application of computer deep learning to electrocardiograms has been progressed in recent years, and I would like to introduce some of them in this article. For example, a study to discriminate paroxysmal atrial fibrillation from an electrocardiogram during sinus rhythm reported a sensitivity of 82% and a specificity of 83%. Similarly, a model predicting a decrease in left ventricular ejection fraction from an electrocardiogram has also been reported. In this way, research that makes it possible to step into the prevention of disease from what was conventionally judged as a normal electrocardiogram is exactly the ideal of preventive medicine and will lead to further increasing the importance of medical examinations in the future Seem.

 The purpose of genetic tests in medical checkup is to know the physical constitution in order to prevent or detect diseases at an early stage. We investigate variants which correlate with each disease. Therefore, multifactorial diseases are targeted. Heterozygotes with familial Hypercholesterolemia (FH) occur at a frequency of 1 in 200 to 500 people in Japan. Knowing the results enables preventive management as diet and drugs, which is an advantage for subjects. FH can be diagnosed biochemically. The significance of genetic tests assists in sharing information within the family and knowing their severity and drug susceptibility. LDLR and PCSK9 are the main causative genes. Patients with both LDLR and PCSK9 mutations have particularly high LDL-C levels and a high incidence of coronary artery disease, such as angina pectoris and myocardial infarction. There are already more than 200 genes associated with type 2 diabetes. Target genes differ depending on what kind of panel is used. Similarly, obesity genes can be prevented by nutritional intervention. Positive results of many oncogenes also require management and careful follow-up. Mutations of TP53 develop malignant diseases since young infants, and the lifetime incidence rate of cancer is as high as 100% in females and 73% in males. In recent years, there are institutions where consumers are directly tested by DTC (direct-to-consumer). However, there are many problems because the risks and preventive effects in Japanese people are not fixed. When introducing genetic tests into a health checkup, it is essential to explain with precise knowledge such as the relevance of the disease and the benefits of knowing, to obtain consent, and to have a counseling system and referral to an appropriate institution.

 The concept of gender-specific medicine began with a review of women's healthcare in the USA. In Japan, the concept of gender-specific medicine was introduced by the author at the Japanese Society of Cardiology in 1999. Lifestyle-related diseases are diseases in which lifestyle habits such as diet, exercise, rest, smoking and alcohol consumption are deeply involved and contribute to their development. Factors contributing to health and ill-health can be broadly divided into (1) Sex (biological differences) and (2) Gender (psychosocial or cultural differences). Factors such as diet, exercise, rest, smoking and alcohol consumption are often discussed in the Gender domain, but the factor that contributes more significantly to lifestyle-related diseases is Sex (differences in sex hormone levels within, between individuals and between men and women). The changes that begin with a lack of estrogen first appear in health check-up data. In a project carried out by Chiba Prefecture between 2002 and 2006, data were collected on a total of 366,862 men and women aged 35 and over, and the results were used to assess obesity, blood pressure, lipids (total cholesterol, LDL cholesterol, neutral fat), liver function (ALT, γ-GTP), creatinine and blood glucose levels (γ-GTP). GTP) and creatinine, with clear gender- and age-specific changes (especially in women at menopausal age). There are two types of estrogen receptor, α and β. The estrogen receptor ERα was discovered in 1966 and the estrogen receptor ERβ in 1996; ERα is mainly distributed in organs involved in female reproduction such as the mammary gland and uterus, whereas ERβ is more widely distributed throughout the body in both sexes and has more extensive physiological significance. Estrogens have anti-atherosclerotic effects such as improvement of blood lipid metabolism, activation of NO synthase from vascular endothelial cells and antioxidant action, and insulin action and cardioprotective effects have also been reported ERβ is also known to be expressed at higher levels in the brain compared to ERα. It is also present in the hippocampus, which is responsible for cognition. In the 100 years of life, a thorough understanding of the relationship between the life cycles of men and women and sex hormones will undoubtedly increase the effectiveness of guidance on the prevention of lifestyle-related diseases.

 Due to COVID-19, the number of people undergoing 5 cancer screenings has declined (5.99 million people in 2019 → 4.35 million people in 2020 → 5.37 million people in 2021), and the number of people undergoing cancer screening in 2021 is 10.3% lower than in 2019. , the impact of the corona crisis continues.

 Comparing the number of women undergoing cancer screening in 2021 and 2019, breast cancer decreased by 9.9% and cervical cancer decreased by 8.0%¹⁾.

 Women's cancer screening rates have traditionally been lower than men's, and are still below the national target of 50%.

 In a survey²⁾ of the reasons why women do not undergo breast cancer screening, "painful, scary, and embarrassing" are cited.

 How to overcome this hurdle and how to disseminate evidence-based cancer screening information will be the key to improving the cancer screening rate for women.

 The year 2020 is said to be the first year of femtech, and the government has included femtech promotion in the "Priority Policy for Women's Participation and Gender Equality 2021" along with the Act on Promotion of Women's Participation and Advancement in the Workplace, Health Management, and Diversity.

 I would like to consider how this trend will provide hints for resolving women's health issues and contribute to cancer screening for women from the perspective of those concerned.

 1) Cancer Society Bulletin No. 714 May 1, 2022

 2) 2013 survey on breast cancer screening by NPO Breast Health Research Association

 We believe that the role of women's medical care in the future is to practice total healthcare that aims to improve and maintain QOL by considering the involvement of each life stage and estrogen in women's health management.

 Conventional general screening for women is mainly screening for female-specific cancers (such as cervical cancer, breast cancer), and other examination items related to women's QOL and well-aging are not covered. There are physical limitations to the time required and cost of health checkups, face-to-face health guidance, etc., and there are large variations in health literacy on the part of examinees. In a super-aging society, the introduction of new solutions is inevitable in order to practice next-generation women's medical care = total healthcare.

 Under such circumstances, fem-tech has been developing in recent years. It is also expected to be used in the scene of female medical examination. According to ‘FemTech Industry Landscape Overview 2021' investors are increasing rapidly every year, and the fem-tech categories currently being put into practical use. These have been covering general medicine, pregnancy & nursing, sexual and reproductive health and contraception, menstrual health, mental health, healthy longevity, menopause care, women's wellness, sexual health, pelvic & uterine health care, and women's total health care.

 When considering the specific use of fem-tech in women's medical examinations, the first step is to understand the type of fem-tech according to the diseases that women want to identify for each life stage and the health problems that affect their quality of life. Next, we think it is necessary to organize the corresponding categories. The use of fem-tech will play a major role in various aspects such as self-assessment, self-care, health literacy, and improvement of access to medical care for individual women's health questions.

 In this paper, I have taken up the proposal for screening for women according to the life stage aiming for total health care, and various fem-tech that are expected in the future, and summarize my personal views on how to use it and prospects.

 Japanese society is currently faced with the need to radically change its traditional ways of thinking and values. The reasons are super-aging, declining birthrate, and depopulation. The impact on various aspects such as the economy, education, and medical care is being touted in the media. The same applies to the impact on the health of citizens, especially on the prevention and early detection of cancer, which is the leading cause of death in Japan. Advances in medicine have led to more effective cancer treatments. However, healthy diet, exercise and early detection remain crucial to reduce the risk of cancer; prevention and early detection are all the more important in Japanese society, where super-aging and depopulation are accelerating. Cancer screening is the cornerstone of early detection, and screening methods are required to be simple and safe. Expectations are growing for liquid biopsy and biomarker measurement, which examine body fluids such as blood and urine and lead to early detection of cancer. However, there are many challenges to be overcome. It is essential that these methods can earn the trust of the public. What kind of systems and rules are necessary to establish liquid biopsy and biomarker measurement that allow citizens to receive medical examinations safely? Introducing several studies in which I am participating, I will consider the challenges for realizing liquid biopsy and biomarker measurement as "cancer screening".