Objective: Using change in interest in ceasing smoking as an indicator, we examined the effectiveness of smoking cessation guidance given during a health check-up.

Methods: In 14,010 subjects (8,812 males, 62.9%; 5,198 females, 37.1%) who had undergone a health check-up both in 2014 and 2015: 1) In order to understand the smoking situation, we analyzed smoking rate by sex, age and occupation and 2) We compared the degree of interest in ceasing smoking in the 2nd year between 113 subjects in a group who received smoking cessation guidance in 2014 (hereafter guidance group) and 964 subjects who did not (hereafter non-guidance group) in order to examine the effectiveness of giving such guidance once a year.

Results: The mean smoking rate was 22.5% (males 30%, females 9.8%). The smoking rate was high in subjects in the 20s to the 40s, and in terms of occupation, it was high in those working in the construction industry, restaurant and hotel industry and wholesale and retail industry. In the comparison of subjects with and without smoking cessation guidance, a significant increase in interest in ceasing smoking was seen in the guidance group in the 2nd year. When the 2 groups were compared in terms of 4 behavior change stages in the 1st year as to whether there was an increase in interest in ceasing smoking in the 2nd year, for the “no interest” stage in year 1, compared with the non-guidance group, there was a significant increase in interest in the guidance group in the 2nd year.

Conclusion: As a significant increase in interest in ceasing smoking was seen in the guidance group as compared with the non-guidance group in the 2nd year, smoking cessation guidance once a year is considered to be effective. While it is important to give smoking cessation guidance to smokers whatever degree of interest they have, there is a particularly high possibility of smoking cessation guidance increasing interest in examinees who are at the no interest stage.

Objective: AminoIndex_TM Cancer Screening (AICS_TM), based on plasma amino acid concentrations between cancer patients and healthy subjects, has been developed as a screening test for seven types of cancer. In this study, associations between AICS ranks and lifestyle habits were investigated to clarify the clinical significance of AICS for cancer prevention.

Methods: AICS values were calculated in 10,102 subjects at Mitsui Memorial Hospital. They were divided into two groups for each parameter based on their answers in an interview card regarding lifestyle habits as well as BMI and diabetes-related parameters, and associations between lifestyle habits and odds ratios that there was at least one rank C in all AICS were determined.

Results: The odds ratio that there was at least one rank C in all AICS was significantly higher in the little or short duration exercise group than frequent or long duration exercise group, in the irregular mealtime group than regular mealtime group, in the groups hardly eating any fish, soy beans, milk/dairy products, fruit, or seaweed than groups eating these foods everyday, in the high alcohol consumption group than low alcohol consumption group, in the smoking group than non-smoking group, in the insufficient sleep group than sufficient sleep group, in the inappropriate BMI group than appropriate BMI group, and in the diabetes group than non-diabetes group.

Conclusion: These results suggested that there was an association between lifestyle habits related to cancer risk, such as exercise and dietary habits, smoking, alcohol intake, obesity, diabetes, and AICS ranks. Lowering cancer risk by improving lifestyle habits could improve AICS ranks, resulting in cancer prevention.

Objective: The mortality rate and population dynamics of colorectal cancer in Fujieda were investigated. Age-adjusted colorectal cancer mortality rates for people under 75 years old were compared between Fujieda and Tokyo.

Methods: The number of colorectal cancer deaths in Fujieda was investigated from 1981 to 2015. We also investigated mortality rate, sex and age for colorectal cancer deaths from 2005 to 2015. The change in the mortality rate with age was observed in ten-year increments. Numbers of deaths and population changes were studied for two age groups: Group a) 40-69 and b) over 70. Age-adjusted mortality rates of colorectal cancer were compared between Fujieda and Tokyo by the direct method.

Results: The number of colorectal deaths from 1981 to 2015 in Fujieda was 920. The colorectal cancer mortality rate was 3% of all fatalities, or 0.02% per population. Colorectal cancer deaths were increasing (p< 0.01). There was no increase in the number of deaths in people under 69 years old from 2005 to 2015 (p< 0.01). Compared with the Tokyo Metropolitan Government age-adjusted mortality rates of colorectal cancer for those under 75 years old, at 5.00 for men and 1.96 for women, there was a tendency for rates in Fujieda City to be lower (vs. 100,000 population).

Conclusion: Mortality from colorectal cancer in Fujieda was increasing as the elderly population increased. In a comparison of the age-adjusted mortality rates of Fujieda and Tokyo, that for Fujieda was lower at 3.34.

Objective: To clarify the influence of smoking on proteinuria, and change in eGFR - its relevance based on an 8-year longitudinal analysis.

Methods: The subjects were 7,476 males (smokers 2,954, previous smokers 2,471, non-smokers 2,051) who were 35 – 65 years old, had a 0.56 – 1.03 mg/dL serum creatinine level at baseline, and had maintained a smoking habit over 8 years. Proteinuria was defined as 1+ or higher in the dipstick test. Percent change in eGFR in each year (PCG) and eGFR decline rate (GDR) were calculated for each subject using the ordinary-least-squares method.

Results: The hazard ratio of smoking to non-smoking for new-onset proteinuria was 1.4 in the non-proteinuria group at baseline. The incidence of proteinuria in smokers was higher than in non-smokers and previous smokers over the entire range of eGFR. Smoking, lower eGFR, elevation of blood pressure, glycemic status, BMI, and uric acid were independent risk factors for proteinuria. The average GDR was –0.48 mL/min/1.73 m²/year. GDR was greater in smokers and previous smokers with proteinuria, younger subjects, and subjects with a higher eGFR. Over 3 years, in subjects without proteinuria in the 1st year who developed proteinuria in the 2nd year, eGFR significantly decreased. In the 3rd year, eGFR recovered in those without proteinuria, while it decreased in those with proteinuria. Smoking, anti-diabetic treatment, and elevation of blood pressure and BMI were risk factors for the latter. The prevalences of –25% and +25% PCG were 2.7 and 6.6%, respectively. Smoking was a risk factor for –25% PCG.

Conclusion: Smoking is a risk-factor for proteinuria. Smokers and previous smokers with proteinuria had a greater GDR. Continuing proteinuria is suggestive of a future decline in eGFR.

Objective: A health insurance union that we are under contract to had the idea of conducting private health check-ups for women with the aim of raising the check-up rate for non-working female dependents. They consulted us in this regard and, beginning in 2011, we conducted such check-ups exclusively for individual health insurance unions.

Methods: We conducted these check-ups 22 times between 2011 and 2016 and had 694 women who had undergone them complete a questionnaire regarding their satisfaction with the check-up after it, and whether they wished to have the same kind of check-up in the following year.

Results: Each time, the questionnaire recovery rate was high (average 92.5%, 642 valid responses). Regarding the reason for choosing a private women’s health check-up, respondents could select several reasons from among the 9 items in the question. Major reasons selected were: a private health check-up was conducted on that day (66.8%), it was on a Saturday (62.1%), the breast cancer screening technician was a woman (45.6%) and the doctor conducting uterine cancer screening was a woman (41.9%). The rate for women wishing to have such health check-ups in the following year was 98.1%.

Conclusion: Factors contributing to the success of private women’s health check-ups exclusively for individual health insurance unions were a feeling that it was something special and that it was carried out on a Saturday. This led to the high rate for customer satisfaction. In the section for optional comments, it was highly evaluated with respondents saying things like “I had a feeling of ease because it was for women only” and “I felt relaxed”. There are few opportunities to undergo health check-ups mandated for non-working female dependents by the Safety and Health Act. Therefore, there is a strong possibility that health check-ups for women planned and conducted by women would raise the rate of female non-working dependents undergoing health check-ups. At present, several health insurance unions are considering basic and more detailed health check-ups exclusively for women.

Objective: In a health care system, encouraging persons testing positive in initial health check-ups to undergo secondary examination is important for ensuring that diseases are not missed at the early stage and definitely treated. At our institution, examinees testing positive in initial health check-ups had been encouraged to undergo secondary examination through interviews with doctors, healthcare guidance by nurses or assistance in making appointments at outpatient clinics from our clerical staff, but it was found that 40% had not visited clinics for secondary examination. In this study, we characterized the profiles of these persons to clarify factors which might influence their decision not to undergo secondary examination.

Methods: 11,658 candidates for secondary examination in FY 2014 were subjected to the analysis, which used medical questionnaire data, and health check-up data.

Results: In single and multivariate analysis, male gender, younger age, no spouse, lifestyle-related disease, no interview with doctor, skipping breakfast, smoking and obesity were found to be significant factors associated with failure to undergo secondary examination.

Conclusions: From these results, daily habits such as smoking, lifestyle disease and skipping breakfast, predisposition toward not heeding encouragement - for instance by not having an interview with a doctor, gender and age should be focused on as risk factors for ignoring encouragement to undergo secondary examination. Creating a system for detecting high-risk persons using these factors may be useful for promoting secondary examination in health care management.

Objective: In recent years, liver cirrhosis and hepatocellular carcinoma associated with increased incidence of nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) have become a problem．In view of this, we evaluated people for fatty liver by abdominal ultrasonography and examined associations between it and metabolic factors.

Methods: Our subjects were 5,436 persons who underwent abdominal ultrasonography in health check-ups in 2015. They were assessed for presence of fatty liver and those with fatty liver were divided into 3 groups according to alcohol consumption as follows: NAFLD-low consumption group, moderate consumption group and ALD-high consumption group.

Results: Fatty liver was detected in approximately 46% of men and 22% of women. There were significant associations of fatty liver with BMI, abdominal circumference, blood pressure, glucose metabolism and liver function tests in all 3 groups, as compared with subjects without fatty liver. Also, in a comparison by alcohol consumption, as consumption increased, TG, HDL-C and liver enzymes were more elevated．In an examination by lifestyle habits, irrespective of gender or alcohol amount, fatty liver was independently associated with “increase in bodyweight of at least 10 kg since age 20”. In men, fatty liver was independently associate with lack of “exercise for a minimum of 30 minutes, at least twice weekly for at least a year” and for moderate alcohol consumption and ALD groups, it was independently associated with “dinner within 2 hours before bedtime at least 3 times a week”.

Conclusion: From a young age, it is important to conduct interventions for lifestyle habits as well as health guidance including that on alcohol consumption.