Objectives Participation in colorectal cancer (CRC) screening is important. However, detailed analyses of pre- and post-disaster screening participation is lacking. We classified a population in terms of CRC screening participation pattern before and after the Great East Japan Earthquake and identified factors that are important in classifying people into such groups. Study design Retrospective observational study Methods We analyzed 21,578 people who were consistently registered in the basic resident register of Minamisoma between 2009 and 2018, using non-hierarchical clustering with the k-means method. After clustering analysis, we identified the factors that distinguish groups with different post-disaster participation changes by classes with high and low pre-disaster participation rates using LightGBM. Results Transition in screening participation rate was divided into four classes. Classes 1 and 2 had high pre-disaster participation; Class 1 recovered after a decline, while Class 2 stayed low, mainly among those still evacuated. The factors separating the two groups were age, sex, and evacuation status. Class 3 and 4 had low pre-disaster rates; Class 3 increased participation post-disaster, especially among individuals under 53 years old. The factors separating the two groups were age and sex. Conclusions Our analysis revealed that CRC screening participation declined among evacuees who had previously participated in screening but increased among older individuals who had not participated before the disaster. Post-disaster screening strategies should be tailored to these groups.
Abstract Objective Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. Although many countries have developed CRC screening guidelines, how CRC screening guidelines are developed across countries remains unclear. This study examined guideline-development funding, stakeholders, and their conflicts of interest (COI), and compared CRC screening recommendations across Group of Seven (G7) countries. Methods We reviewed the most recent CRC screening guidelines issued by official research organizations or governmental bodies in G7 countries. We extracted information on responsible organizations, panel composition, recommendations, target ages, screening tests and intervals, supporting evidence, funding, and COI. Results While CRC screening recommendations showed some similarities across G7 countries, some differences were observed in starting age, screening modality, and implementation structure. Differences were also identified in funding, COI reporting and management, and stakeholder composition, including limited involvement of patient and public representatives. Conclusions Colorectal cancer screening guidelines among G7 countries varied despite shared international evidence. These differences likely reflect country-specific factors, including population characteristics, screening participation, health system capacity, and cultural context. Given that guideline development involves diverse stakeholders, ensuring transparency in the guideline-development process is essential.
BACKGROUND:Financial ties between healthcare professionals and the medical-device industry raise conflict-of-interest and transparency concerns; despite Japan's 2012 self-regulatory guidelines, device-related payments receive less scrutiny than pharmaceutical payments globally, including in Japan. OBJECTIVE:To provide the first detailed analysis of honoraria from medical device companies to Japanese physicians in 2019, offering a baseline before the COVID-19 pandemic. METHODS:We retrospectively examined 2019 payment data from the Yen for Docs database, compiled from disclosures by 118 companies affiliated with the Japan Medical Devices Network and other major firms. The analysis focused on honoraria-lecture, consulting, and writing fees-because these are the only categories disclosed with individual healthcare professionals names. Payments were standardized, cleaned, and aggregated at company and recipient levels. Descriptive analyses identified overall volume, company distribution, and top-earning specialties. RESULTS:In 2019, 66 companies disclosed 60,161 honorarium payments totaling USD 46.0 million. Most funds (66.7%) were lecture fees, followed by consulting (28.8%) and writing (4.5%). Payments were highly concentrated: the top 10 companies accounted for 63.3% of the total, led by Medtronic, Terumo, and Johnson & Johnson. Among 24,434 recipients, 66.1% received less than USD 1,000, while only seven physicians received more than USD 100,000. Cardiologists (48.0%) and cardiovascular surgeons (24.0%) dominated the top 50 earners. CONCLUSION:Honoraria from Japan's device industry were modest in scale compared with pharmaceutical companies but highly concentrated among a few firms and cardiovascular specialists. These findings highlight the need for more comprehensive and legally enforceable transparency frameworks to safeguard clinical integrity and public trust.
Diphyllobothrium balaenopterae infection is a zoonosis mainly reported in Japan and it is associated with raw fish consumption. The reported cases in Japan show geographical clustering, mainly in the Pacific coastal areas and in western Japan. Reports from the Tohoku region are scarce, resulting in limited clinical awareness of this disease among local practitioners in Japan. A man in his 20s, residing in the Pacific coastal area of the Tohoku region, presented with diarrhea and the anal expulsion of string-like material. He had no notable past medical history but reported frequent consumption of raw juvenile Japanese anchovy 2-3 months prior to onset. Although taeniasis was clinically suspected, a fecal examination for ova was negative, thus complicating the diagnosis. GastrografinⓇ (amidotrizoate meglumine and sodium solution) spraying into the duodenum via endoscopy enabled the recovery of a 2.0-m immature tapeworm. A molecular biological analysis targeting the mitochondrial cox1 gene of the worm confirmed the diagnosis of a Diphyllobothrium balaenopterae infection. No further proglottid discharge or gastrointestinal symptoms occurred during the six-month clinical follow-up. This case highlights the clinical significance of considering D. balaenopterae, even in non-endemic areas, recognizing the limitations of stool ova testing in immature infections, and preserving the worm for molecular identification.
