The relationships between compliance with fecal occult blood testing (FOBT), the number of participants in FOBT, positive rate of FOBT, history of a diagnostic examination after FOBT, and compliance with the diagnostic examination were studied in a worksite setting using a database containing individual data from a mass screening and other health care checks. The subjects were 2, 421 males and 210 females with positive FOBT between 2000 and 2002. Of these, 1,816 males (75.0%) and 144 females (68.6%) underwent diagnostic examinations. A logistic regression analysis was used to investigate the relationships between the factors. In the model, follow-up with a diagnostic examination was denoted as the dependent variable, with the other factors as independent variables. The variables in the analysis were standardized to compare the magnitude of each variable; factors with large negative values were considered the most important in limiting follow-up diagnostic examination. A need for frequent diagnostic examinations and a high rate of positive tests were factors that caused FOBT participants to refrain from having the diagnostic examination. Compliance with FOBT was the only positive relationship with statistical significance.
A high positive FOBT rate could impair the reliability of mass screening. To address this problem, FOBT kits should be re-evaluated, and the scheme used for mass screening of individuals who undergo frequent diagnostic examinations but whose results are normal should be improved.

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For the OC-Hemodia (quantification method using an autoanalyzer) of the LA method that is most commonly used among various types of reagents for immunological occult blood examination in colorectal cancer screening in Japan, a new autoanalyzer and a special sample collection container were recently developed. We measured the hemoglobin detection sensitivity of this new measurement system using artificial feces. When the cut-off value recommended by the manufacturer (100ng/ml) was used, the hemoglobin detection sensitivity limit was 25-30μgHb/g artificial feces. When hemoglobin detection sensitivity was evaluated with a reduction in the cut-off value from the recommended value, cut-off values to 30ng/ml were considered to be practical. In this cut-off value range, the hemoglobin detection sensitivity limit was 7.5-10μgHb/g artificial feces.
On the other hand, the hemoglobin detection sensitivity of Immudia-HemSp (qualitative method by visual observation) of the RPHA method that is also widely used in colorectal cancer screening was also measured using artificial feces. Using the cut-off value according to the manual, the hemoglobin detection sensitivity limit was 15-30μgHb/g artificial feces.
The hemoglobin detection sensitivity of the LA method using this new measurement system became higher than that of the RPHA method by reducing the cut-off value.

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The prevalence of fatty liver among the occupational population and its relationship to the laboratory data were examined in this screening. The factors which announce the future appearance of fatty liver were examined. The prevalence of fatty liver increased from 24.3% to 27.5%, and 11.4% of persons without fatty liver for the last seven years developed fatty liver. The result values of the liver function test and the prevalence of factors which lead to life-style related diseases were high in the fatty liver group. The values of BMI, ALT, systolic blood pressure, total cholesterol, and triglyceride were high in patients who developed fatty liver, as compared to persons who had no fatty liver for the last seven years. Careful monitoring of signs announcing the onset of fatty liver is thought to be necessary for these patients.

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Secondary prevention is given priority in current cancer screenings in detriment to primary prevention. An evaluation of eating habits and education is made by analyzing the health survey questionnaires sent the examinees undergoing health checkups, based on for four points: A) facts related to the living environment, B) facts related to the frequency of food intake, C) facts related to dietary life, and D) facts related to the anamnesis of the examinee and his or her family). Eating habits are diagnosed and corrected based on five points:
1) how to consume the food, 2) how to consume breakfast, 3) how to consume salt, 4) how to consume vegetables and 5) interest in eating). It is important for examinees to review their eating habits at health checkups, and to have a chance to improve their lives from the viewpoint of preventing of life-style-related diseases and cancer.
The secondary prevention, by the recommendation of having cancer screening, is also important, and, furthermore, it is thought that the examinee's understanding of the benefits of healthy eating habits and exercise, based on a detailed history compiled by the health survey questionnaire, and a suggestion from the physician to the examinee regarding the improvement of his or her life-style, can lead to the primary prevention of cancer.

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