title: Challenges in breast and cervical cancer control in Japan.
abstract: Since the mid-1990s, there has been an increasing incidence of, and mortality from, cervical and breast cancers in Japan. Such an increase has raised concerns over the efficiency of Japan's screening programmes for these cancers. Although citizens benefit from universal health coverage, the Japanese health insurance system mostly focuses on tertiary prevention and disease treatment, while secondary prevention (screening) is low priority. Citizens have multiple opportunities to be screened for cancer-either through programmes organised by municipalities, or individual or collective, opportunistic and comprehensive health check-ups on a voluntary basis. Despite this, however, participation is as low as 35% of the target population for both cancers. In this Policy Review, we discuss the challenges in the prevention of breast and cervical cancers in Japan, particularly focusing on the structure of the National Health Insurance system and the National Cancer Control Plan, reasons for low participation as a result of social and political attitudes, as well as providing recommendations to overcome these challenges. Japanese women would benefit from new measures to increase participation, a national data surveillance programme to monitor screening activities, and the implementation of a quality assurance system among all providers.
authors.affiliation: Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France. Electronic address: sauvagetc@iarc.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sauvaget
authors.affiliation: Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Nishino
authors.affiliation: Department of Obstetrics and Gynaecology, Jichi Medical University, Saitama Medical Centre, Saitama, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Konno
authors.affiliation: Department of Obstetrics and Gynaecology, Miyagi Cancer Centre, Natori City, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Tase
authors.affiliation: Department of Health Science, School of Medicine, Tokushima University, Tokushima, Japan.
authors.forename: Tadaoki
authors.initials: T
authors.lastname: Morimoto
authors.affiliation: Miyagi Cancer Society, Sendai, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Hisamichi
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007564:Japan; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control*