CT colonography (CTC) shows the same accuracy for detecting colorectal tumors as colonoscopy, and the quality of CTC examinations is not affected by radiographer skill or experience. The procedure is minimally invasive and safe, and thus, CTC is suitable for colorectal cancer screening. CT is expected to be a detailed evaluation method for patients with positive fecal immunochemical test results and is also useful for primary screening during comprehensive medical examinations.

  Japan has the largest number of CT instruments worldwide. In Japan, the use of automatic carbon dioxide insufflation equipment received regulatory approval in 2011, and CTC has been covered by insurance since 2012; a CTC-dedicated barium contrast agent was approved as a pharmaceutical and medical device in 2016. These factors have resulted in widespread CTC use. Although the infrastructure has improved, issues such as variability in bowel preparation and availability of radiologists need to be considered. The number of deaths from colorectal cancer in Japan is increasing, and therefore, it is important to improve screening and close examination rates to reduce colorectal cancer mortality.

  Highly receptive and safe CTC is expected to represent a means of improving the sluggish screening and close examination rates. To reduce colorectal cancer mortality, it is important to efficiently incorporate CTC in colorectal cancer screening, which has been mainly performed using the fecal occult blood test, and build an effective and systematic screening system.

Objective: We investigated the current approach adopted for evaluation of thyroid nodules based on palpation and carotid echocardiography and the appropriate methods for thyroid nodule screening.

Methods: Among all patients who visited our hospital, 51 with a thyroid nodule were investigated over 1 year and 9 months. Of these, 48 were newly diagnosed and were categorized into the palpation and carotid artery ultrasonography groups.

Results: The palpation and carotid artery ultrasonography groups included 20 and 28 patients, respectively. The mean maximum diameters of nodules were 2.4 and 1.5 cm in the palpation and carotid artery ultrasonography groups, respectively. In the palpation group, results of detailed evaluation were confirmed in 19 patients, fine-needle aspiration cytology (FNAC) was performed in 10 patients, and cancer was detected in 2 patients. In the carotid artery ultrasonography group, results of detailed evaluation were confirmed in 20 patients, FNAC was performed in 12 patients, and cancer was detected in 2 patients. Thyroid cancer, which necessitated surgery occurred in two patients in each group.

Conclusions: Based on neck palpation, we diagnosed two patients with thyroid cancer that necessitated surgery. We conclude that neck palpation performed at routine health checkups could be a useful strategy for thyroid nodule and cancer detection.

Objective: As population aging has been advancing in Japan in recent years, measures against the development of locomotive syndrome have been emphasized. Our healthcare center initiated health screening for patients with locomotive syndrome as an option in their health examination. During this screening, a health and fitness instructor conducts tests to evaluate the risk of locomotive syndrome, explains the results, and provides exercise guidance. Relatively healthy individuals with few elderly adults undergo this screening. The significance of screening such a population for locomotive syndrome has not been fully clarified. However, the measures against metabolic syndrome (MetS) constitute an important issue. It is expected that the test to evaluate the risk of locomotive syndrome may be a useful trigger for behavioral changes. This study aimed to clarify the significance of screening for locomotive syndrome as part of the comprehensive health checkup.

Methods: A total of 941 subjects aged 65 years or older who underwent screening for locomotive syndrome were included in a multiple regression analysis. In the analysis, the results of the test to evaluate the locomotive syndrome risk were regarded as objective variables. F-test and chi-squared test were conducted to assess the test results. Furthermore, changes in the test results of subjects who underwent screening in the second consecutive year and changes in each test conducted to evaluate the locomotive syndrome risk were examined.

Results: More than 60% of the subjects aged 65 years or older who underwent screening were diagnosed with locomotive syndrome. The factors associated with the development of locomotive syndrome included sex, age, and abdominal circumference. Increases in age, body-mass index (BMI), and abdominal circumference were associated with the development of locomotive syndrome. BMI of 25 kg/m² or higher and excessive abdominal circumference were associated with MetS and locomotive syndrome, respectively. Improvements were observed in subjects who underwent screening in the second consecutive year.

Conclusions: The findings of this study suggest that screening for locomotive syndrome, which comprises a test to evaluate the locomotive syndrome risk and exercise guidance as part of the comprehensive health checkup at our healthcare center, is a useful trigger for behavioral changes.

Objective: We performed simultaneous ultrasonography (US) screenings of the thyroid gland and carotid artery on examinees in Ningen Dock. We report on the results of the thyroid lesions and discuss the potential problems associated with incidental thyroid nodules detected with US.

Subjects and Methods: The examinees included 12,827 people who underwent regular health checkups from 2010 to 2013. These checkups included optional cervical US examinations. The number of men and women who underwent these health checkups was almost equal. The mean age was 56.8±11.0 years. In examinees where a high frequency of minor innocent lesions was present in the thyroid gland, we set up an original set of criteria for deciding when to proceed with further detailed examination, both for the sake of patient well-being and for the early detection of underlying conditions. Detailed examination for suspicion of thyroid malignancy was undertaken for thyroid lesions greater than 5mm and follicular tumors greater than 10mm.

Results: Almost half of the examinees had various thyroid gland lesions such as cysts or adenomatous nodules. Over the 4-year period, 1.6% of the examinees who underwent US examination required detailed examination, and 57.1% of these examinations were performed in our hospital. Fifty-four of these examinees were found to have thyroid cancer. Among these, 18 were diagnosed as having papillary thyroid microcarcinoma. The discovery rate of thyroid cancer in this Ningen Dock population was 0.42%, and the presumptive incidence of thyroid cancer was 0.74%.

Conclusions: It is suggested that thyroid US screening using our proposed criteria as part of the regular Ningen Dock checkup is useful for the early detection of thyroid cancer. In the event that individuals are diagnosed with papillary thyroid microcarcinoma, they need to be treated with care.

Objective: To evaluate the results of individual health guidance, tracking, and follow-up of individuals who received lifestyle-related disease C judgment, and consideration of future issues.

Methods: Out of the 4,497 individuals who presented at our facility’s Comprehensive Health Checkup System between October 2017 and March 2020, 1,856 received C judgment for either blood pressure, blood glucose or lipid testing, and subsequently received individual health guidance and action plans implemented after explanation from a physician. The newly created follow-up materials for C judgment were used for guidance. Recipients were recommended to proactively implement positive improvement behaviors, undergo follow-up testing and report the results by mail. Follow-up results were compared using a t-test.

Results: Among C judgment recipients, the largest group (77.7%), had issues in only one of the factors, blood pressure, blood glucose, or lipid test, of these the most common were lipid test issues. Response rates for follow-up results were high among blood glucose test recipients, and low among lipid test recipients. Apart from the blood glucose and lipid test group, which were excluded for returning less than the minimum five responses, significant improvements in actual measurements between the comprehensive checkup and the follow-up were indicated.

Conclusions: Significant test value improvements were indicated for many of the C judgment recipients who underwent individual health guidance and follow-up testing, suggesting the effectiveness and importance of health guidance and follow-up testing for C judgment recipients.

  A 49-year-old woman presented with a circumscribed oval, partially lobulated, 6mm mass lesion at the C area of the left breast on ultrasonography. The absence of blood flow signal and the existence of front edge arch high echo suggested the presence of a complicated cyst. On the same day, fine needle aspiration cytology (FNAC) was performed to rule out malignancy especially solid-type invasive ductal carcinoma. Pale yellowish white viscous liquid was aspirated without ductal cells on microscopic examination. Results indicating a complicated cyst were consistent. Follow-up was conducted by annual human dry dock.

  We can reduce the patient’s burden to visit secondary medical institutions for further detailed examinations another day by examining FNAC on the same day as ultrasonography and the hospital’s burden by excluding cysts from detailed inspection.