Objective: The purpose of this study was to investigate the possibility of implementing cancer education for upper grade elementary school pupils.

Methods: We conducted a document analysis on government guidelines for teaching as well as a semistructured interview with five teachers who were responsible for primary school education in metropolitan Japan. Regarding the document analysis, the latest government guidelines for teaching at primary and junior high school were downloaded from the website of the Ministry of Education (162 pages,150, 908letters) and a dataset (in Adobe Acrobat PDF) was developed to use for the review. Some keywords seemingly related to cancer education were set to run searches on the dataset. We sorted and analyzed the number of keywords for relevant grades, subjects, and detail contents of the subjects. We did not focus on quantitative measures on cancer education relevancy to the government teaching guidelines, but rather on its trends. Regarding the semi-structured interview, a group interview was conducted concerning knowledge about cancer, teaching styles in general, general teaching materials that they would desire, sources of teaching information, and attitude toward cancer education. Qualitative analysis was used to capture perspectives related to teachers' perceptions about cancer education by extracting codes, sub categories and categories from the interview text data.

Results: The document analyses showed the relevancy of cancer education at all grades of primary and junior high school and several subjects. From the qualitative analysis on the interviews with five teachers, thirteen identified codes for teachers' idea about cancer education emerged and were grouped into five sub categories (“teacher's accurate knowledge," “connection with the school's educational principle," “connection with possible subjects for cancer education," “negative imagination formation," and “teacher's prejudice about cancer").

Two categories were then abstracted: “the sense of possible cancer education," and “the sense of impossible cancer education." Finally a structured model showed the relationship among the categories, considered the process of shaping teachers' idea of cancer education.

Conclusions: The results from this study, consisting of analyses on the content of teaching guidelines and interviews with school teachers, showed the possibility of cancer education for upper grade elementary school pupils. It is suggested that encouraging teachers to obtain accurate knowledge about cancer and to build supportive environments for providing cancer information are necessary. Further research to verify the model as well as to assess impacts when cancer education is widely implemented utilizing health impact assessment for cancer education is needed.