Clinical Epidemiological Studies of Colorectal Cancer by Record Linkage of Cancer Registries and Biospecimen Data: A Systematic Review.

BACKGROUND: The incidence and prognosis of colorectal cancer are associated with lifestyle, family history, and genetic predisposition. Record linkage between cancer registries and biospecimen data would enable us to conduct clinical epidemiological studies on incidence or prognosis including genome information. In this study, we conducted a systematic review of clinical epidemiological studies of colorectal cancer using record linkage between cancer registries and biospecimen data and examined the possibilities for future use of this linkage. METHODS: We searched PubMed and Google Scholar for articles regarding cancer registries and biospecimen data use published before December 2021. Selected articles were summarized by cancer registry use, biospecimen use, exposure, outcome, informed consent, and participant numbers by study design and type of cancer registry. RESULTS: Of the 2,793 identified articles, 81 studies were included in this review. The most frequently used cancer registries and study design were site specific cancer registries and cohort studies. Most use of cancer registries was for patient selection in cohort studies and case selection in case-control studies. Most use of biospecimen data was for prognostic factors in cohort studies and risk factors in case-control studies. In site specific cancer registries for the examination of familial colorectal cancer, most use of biospecimen data is to examine genome mutation, expression, or deficiency. CONCLUSION: We suggest that record linkage between cancer registries and biospecimen data would enable the accurate capture of outcomes and detailed genome-environmental factors, and to conduct clinical epidemiological studies according to specific research questions and tailored study designs.

[A Systematic Review of Clinical and Epidemiological Studies Using Record Linkage Data between Hospital Based Cancer Registries and Biospecimen Data].

INTRODUCTION: Recently, registry-based cancer research linking biobanks with clinical information has become practical. In fact, hospital-based cancer registries(HBCR)are considered appropriate for basic medical information provision to link with biospecimen data since they can capture accurate information about cancer incidence and prognosis. The aim of this systematic review was to examine HBCR and biospecimen data uses in clinical and epidemiological studies. METHODS: We searched PubMed and Google Scholar for articles regarding HBCR and biospecimen data uses published before November 2019. Selected articles were summarized by study design into HBCR usage, biospecimen data usage, exposure, outcome, informed consent, and participant numbers. RESULT: Of the 2,767 identified articles, 148 studies were included in this review. In cohort studies, most HBCR usage was noted for patient selection, and most biospecimen data usage was factors affecting prognosis. Meanwhile, in case-control studies, most HBCR usage was noted for cancer incidence identification, and most biospecimen data usage was factors affecting cancer incidence. CONCLUSION: HBCR and biospecimen data usage in clinical and epidemiological studies were found to be different based on study design. Linkage of HBCR and biospecimen data will enable researchers to conduct clinical and epidemiological studies that correspond to varying research question types.

Geographical socioeconomic inequalities in healthy life expectancy in Japan, 2010-2014: An ecological study.

BACKGROUND: Area differences in life expectancy (LE) and healthy life expectancy (HLE) in large geographical units have been monitored around the world. Area characteristics may be based on culture, history, socioeconomic status and discrimination in smaller geographical units, so it is important to consider these when looking at health inequality. We aimed to evaluate LE, HLE, and non-healthy life expectancy (NHLE) in 1707 municipalities using Areal Deprivation Index (ADI) in Japan for the first time. METHODS: We calculated the observed LE, HLE, and NHLE using death, population, and Long-term care insurance data for 2010-2014 and applied the variance weighted least squares model to estimate LE, HLE, and NHLE by 100 percentiles using the standardized ADI. FINDINGS: The estimated LE, HLE, and NHLE became lower as the deprivation index worsened: the differences between the most and least deprived areas for HLE were 2·49 years for LE and 2·32 years for HLE in males; 1·22 years for LE and 0·93 years for HLE in females. The observed LE and HLE in the most deprived areas were much lower than other areas. INTERPRETATION: Using ADI has enabled us to see the disparity within municipalities precisely. LE and HLE outlier for the 100th percentile might be linked to historical areal deprivation and marginalization. Precise monitoring of socioeconomic status-based health inequalities could help manage these inequalities by identifying the groups most in need of intervention. FUNDING: The Ministry of Education, Science and Culture of Japan (a Grant-in-Aid for Scientific Research [A] No. 20H00040 and 18H04071).

[Current status and intention to change indoor smoking rules by enforcing smoke-free legislation in Japan].

Objective　In Japan, the revised Health Promotion Act and the Tokyo Metropolitan Ordinance to Prevent Exposure to Second-hand Smoke have been in place since April 1, 2020. However, regional differences in the prohibition of smoking in restaurants have raised concerns that some restaurants are not regulated by the smoke-free legislation. In addition, outdoor smoking rules have been in place in municipalities prior to the smoke-free legislation, so smoking outside restaurants may occur, and this may obstruct progress in the prohibition of smoking. In this study, we examined the indoor smoking rules before and after the enforcement of the smoke-free legislation, as well as what influenced the changes in these rules.Methods　We conducted a self-administered questionnaire survey in 6,000 restaurants in Tokyo, Osaka, and Aomori prefectures from February to March 2020. We examined the indoor smoking rules before and after the enforcement of the smoke-free legislation and calculated the proportion of change by categorizing the indoor smoking rules into "smoking prohibited," "smoking permitted in separate area," and "smoking permitted."Results　Of the 879 restaurants that responded, 603 indicated that they were not regulated by the smoke-free legislations. The percentage of restaurants that switched from "smoking permitted in separate area" and "smoking permitted" to "smoking prohibited" was 5.2% (3/58) in Tokyo, 23.1% (31/134) in Osaka, and 17.2% (57/326) in Aomori. In addition, when we included restaurants that were already "smoking prohibited" before the enforcement and did not plan to change the rules after the enforcement, the percentage was 46.6% (55/118) in Tokyo, 49.6% (113/228) in Osaka, and 48.6% (125/257) in Aomori.Conclusion　In total, 17.6% (91/518) of the restaurants that were not regulated by the smoke-free legislations would plan to change their indoor smoking rules from "smoking permitted in separate area" and "smoking permitted" to "smoking prohibited." There is a concern regarding the reduction in customers and sales due to the prohibition of smoking, and the existence of outdoor smoking rules prior to the smoke-free legislation may obstruct progress in the prohibition of smoking. It will be important to examine changes in the number of customers and sales resulting from changes to the indoor smoking rules to deal with smokers when smoking is prohibited, and to improve environments set as public smoking spaces in Japan.

[Comparison of the two methods of defining high-stress on the Japanese Stress Check Program].

OBJECTIVES: In Japan, companies are required to implement a "stress check program" to prevent mental health problems in workers. To identify "high-stress" workers, the Brief Job Stress Questionnaire (BJSQ) is recommended. According to the stress check program manual issued by the government, high-stress can be defined using two criteria, either the "sum method" (simply summing the scores for each scales) or the "score converted method" (using converted scores according to the conversion table for each scales). In this study, we examined the differences in results found using these two criteria on "stress check program" data. METHODS: We used data of 71,422 workers in 117 companies and organizations who conducted stress checks in 2016. The prevalence of high-stress was calculated by applying the two criteria simultaneously, and the chi-square test was used to compare the proportion of workers with high-stress. We subsequently divided participants into the four following groups and calculated the proportion of each group: group A was defined as having high-stress by both criteria; group B, only by the sum method; group C, only by the score converted method; and group D, not defined as high-stress by either criterion. We compared the average values of stress response among four groups using the Kruskal-Wallis test, and further compared the average values between group B and group C using the Bonferroni method. RESULTS: The average age of participants was 43.7 ± 11.1, and 66.8% were males. The proportion of those defined as having high-stress were 11.7% using the sum method and 13.2% using the score converted method; the proportion of high-stress workers was thus significantly higher when using the score converted method (p <.001). Physical stress response was higher in group B; however, lack of vigor, irritation, fatigue, and depression were higher in group C (p <.01). CONCLUSIONS: Compared to the sum method, 1.5% more high-stress workers were observed using the converted method, and this result was similar for individual and employment-related factors. Furthermore, workers were more likely to be judged as having "high-stress" when the score of the physical stress response was higher in the sum method. Hereafter, it is important to consider which criteria are applied when discussing proportions of high-stress. Further research is needed to examine which criteria will predict health disorders.

Associations of older adults' excursions from home with health-related physical activity and sedentary behavior.

BACKGROUND: As people age, they spend more time in and around their domestic environments, within which opportunities for health-enhancing physical activity (PA) may be limited. We examined the associations of frequency of excursions from home with accelerometer-determined PA and the total and prolonged sedentary behavior (SB, sitting for ≥30 min) among community-dwelling older adults. METHODS: Overall, 434 older adults (men, 57.1 %; age, 70-79 years) wore an accelerometer (HJA-350IT, Omron Healthcare) for 7 days. Time spent in SB, light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and prolonged SB bout (≥30 min) were calculated. Frequencies of excursions from home were categorized as 0-3, 4-5, and 6-7 days/week. Associations of excursions with PA and SB were tested by analysis of covariance adjusted for sociodemographic characteristics. RESULTS: Frequencies were 14.3 %, 31.1 %, and 54.6 % for excursions 0-3, 4-5, and 6-7 days/week, respectively. For men, less frequent excursions from home were significantly associated with less MVPA and more total and prolonged SB times (estimated means [minutes/day]: MVPA, 32, 42, and 48; total SB, 589, 549, and 539; prolonged SB, 344, 288, and 265; respectively; p < 0.05). LPA was not statistically significant (p = 0.09). For women, less frequent excursions were significantly associated with all PA outcomes (SB: 536, 497, and 467; prolonged SB: 260, 213, and 204; LPA: 328, 363, and 379; MVPA: 36, 39, and 54, respectively). CONCLUSIONS: Among community-dwelling Japanese older adults, more frequent excursions from home were associated with more PA, less SB, and more-favorable SB patterns, suggesting a potential strategy for preventive-health initiatives.