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1.
J Diabetes Investig ; 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32022988

RESUMO

Cancer patients with diabetes experience a poorer prognosis, yet the population burden of this multimorbidity remains unknown. This study aims to estimate the latest incidence and prevalence of cancer with diabetes mellitus in Japan. We used projection of cancer incidence and latest survival data from population-based cancer registries. Incidence of cancer associated with diabetes was estimated separately for patients with pre-existing diabetes and those without diabetes, and used to estimate the 5-year cancer prevalence in those with and without diabetes. The prevalence of pre-existing diabetes in cancer patients at any cancer site was estimated to be 20.7% (647,160 men and women). Among cancer sites, diabetes prevalence was high in patients with liver and pancreatic cancers in both sexes. In conclusion, our study shows a large burden of diabetes in cancer patients in Japan, which warrants further attention by health practitioners and policy-makers.

2.
Nihon Koshu Eisei Zasshi ; 67(1): 3-14, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32023592

RESUMO

Objective This report aimed to present policy recommendations on the regulation of heated tobacco products based on a review of the literature on the use of heated tobacco products, component analysis of harmful chemical substances, and product characteristics as nicotine delivery device, and on an examination of the influence of the product's increasing usage to the main measures of tobacco control.Methods The literature search was performed using Japan Centra Revuo Medicina and PubMED database. The search yielded 11 articles that examined the use of heated tobacco products, component analysis of harmful chemical substances, and product characteristics as nicotine delivery device. Eight articles were additionally collected from reports of public health research in Japan and public reports in foreign countries. The six main policies advocated by World Health Organization as MPOWER (Monitor, Protect, Offer, Warn, Enforce, Raise) were adopted in considering the expected influence of this product's increasing usage this product epidemic on tobacco control. In addition to the abovementioned 19 articles, 26 documents and materials related to the status of tobacco control were collected and used to examine the influence of the product's increasing usage to the main measures of tobacco control.Results In Japan, heated tobacco products have been available since December 2013, and the spread of use has risen remarkably since 2016. As of October 2016, Japan consumed more than 90% of the heated tobacco products sold internationally. Compared with cigarettes, heated tobacco products can reduce exposure to harmful substances except nicotine. However, their use does not lead to reduced risk of illness. The reduction of exposure to harmful substances cannot be expected when used in combination with cigarettes. Heated tobacco products and cigarettes have similar nicotine exposure levels and pharmacokinetics; thus, use of the former results in nicotine dependence and exacerbates the difficulty in discontinuing tobacco consumption. The popularity of heated tobacco products could adversely affect any of the six main measures of tobacco control.Conclusion Although public health concerns have been identified for the popularity of heated tobacco products, evidence remains insubstantial for the formulation of regulatory implications. Additional research is needed on the health effects to users and bystanders, effects on cigarettes use, and influence on tobacco control policy. From the perspective of the precautionary principle of public health, the same regulation as for cigarettes should be implemented as regards heated tobacco products until their health effects are fully elucidated.

3.
Medicine (Baltimore) ; 98(51): e18315, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860982

RESUMO

The incidence of breast cancer among Japanese women is substantially increasing. This study evaluated the effects of reproductive and lifestyle factors with respect to breast cancer overall and separately among pre- and postmenopausal women using data from the Three-Prefecture Cohort Study of Japan.A total of 33,410 women aged 40 to 79 years completed a self-administered questionnaire, which included items about menstrual and reproductive history and other lifestyle factors. The follow-up period was from 1984 to 1992 in Miyagi and 1985 to 2000 in Aichi Prefectures. We used Cox proportional hazards regression models to estimate hazards ratios (HRs) and 95% confidence intervals (CIs) after adjusting for confounding factors.After 9.8 mean years of follow-up, 287 cases of breast cancer were recorded. In the overall analysis, later menarche (≥16 years) and parity were significantly associated with a decreased risk of breast cancer, with HRs of 0.69 (95% CI 0.48-0.99) and 0.72 (95% CI 0.52-0.99), respectively. Further, there was a significant decline in the risk of breast cancer with increasing number of birth among parous women (P for trend = .010). On the contrary, a family history of breast cancer in the mother was significantly associated with an increased risk of breast cancer (HR 3.22, 95% CI 1.52-6.84). Analyses based on menopausal status at baseline indicated that height (≥160 cm) and weight (≥65 kg) were significantly associated with an increased risk of postmenopausal breast cancer, with HRs of 1.34 (95% CI 0.72-2.50) and 3.13 (95% CI 1.75-5.60), respectively. Risk associated with BMI significantly differs by menopausal status.Our findings suggest the important role of reproductive factors in the development of breast cancer in Japanese women; however, body mass index (BMI) may have different effects on breast cancer in Japanese women compared with western women.


Assuntos
Neoplasias da Mama/etiologia , Adulto , Idoso , Índice de Massa Corporal , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Estudos de Coortes , Feminino , Humanos , Japão/epidemiologia , Estilo de Vida , Anamnese , Menarca , Pessoa de Meia-Idade , Paridade , Fatores de Risco , Inquéritos e Questionários
6.
Circ J ; 83(4): 757-766, 2019 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-30853684

RESUMO

BACKGROUND: Coffee, which contains various bioactive compounds, is one of the most popular beverages. Further accumulation of evidence is needed, however, to confirm whether coffee consumption would be effective in preventing cardiovascular disease in the general Japanese population. Methods and Results: We evaluated the association between coffee consumption frequency (never, sometimes, 1-2 cups/day, 3-4 cups/day and ≥5 cups/day) and mortality from all causes, heart disease, and cerebrovascular disease, in 39,685 men and 43,124 women aged 40-79 years at baseline, in a 3-prefecture cohort study. The coffee consumption frequency was assessed on questionnaire. Cox proportional hazards regression modeling was used to assess the association between coffee consumption frequency and all-cause and cardiovascular disease mortality with adjustment for potential confounders. During 411,341 and 472,433 person-years in men and women, respectively, a total of 7,955 men and 5,725 women died. Coffee consumption frequency was inversely associated with all-cause mortality in both genders (P for trend<0.001). In addition, the risks of mortality from cerebrovascular disease in men (P for trend<0.001), and heart disease in women (P for trend=0.031) were inversely associated with coffee consumption. CONCLUSIONS: In this Japanese population, coffee drinking has a preventive effect on all-cause and on cardiovascular mortality in men and/or women.

8.
J Diabetes Investig ; 10(3): 827-836, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30290067

RESUMO

AIMS/INTRODUCTION: To examine the association between adult-onset diabetes and life-course bodyweight changes. MATERIALS AND METHODS: In a cross-sectional study, 17,398 Japanese female nurses aged ≥30 years completed a self-administered questionnaire in 2001-2007. Bodyweight indices were calculated for three life stages: birthweight (adjusted for gestational age), body mass index (BMI) at age 18 years and current BMI. Odds ratios for being diagnosed with adult-onset diabetes were calculated according to the combined bodyweight categories of two life stages: at birth and age 18 years; and at age 18 years and the survey (current). Path analysis was carried out to decompose the effect of each bodyweight index into direct and mediating effects. RESULTS: After adjustment for age at survey and parental diabetes history, "low" birthweight (<25th percentile), when combined with either "low" or "high" BMI (≥75th percentile) at age 18 years, had significant odds ratios (2.32, 95% confidence interval [CI] 1.22-4.44; 3.69, 95% CI 2.12-6.42, respectively) compared with the group of "middle" category (25th-74th percentile) at both life stages. The combination of "low" BMI at age 18 years and "high" current BMIs showed the highest odds ratio (7.97, 95% CI 3.97-16.00). Among women without parental diabetes history, "low" BMI at age 18 years showed a significantly high odds ratio (2.25, 95% CI 1.01-4.99), even when combined with the "middle" category of current BMI. Path analysis showed that both birthweight and BMI at age 18 years had a negative direct effect on adult-onset diabetes. CONCLUSIONS: Underweight at adolescence, as well as overweight, is a potential risk factor for adult-onset diabetes among Japanese women.


Assuntos
Biomarcadores/análise , Diabetes Mellitus Tipo 2/epidemiologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Sobrepeso/complicações , Magreza/complicações , Adolescente , Adulto , Idade de Início , Glicemia/análise , Estudos Transversais , Feminino , Seguimentos , Humanos , Japão/epidemiologia , Gravidez , Prognóstico , Estudos Prospectivos , Adulto Jovem
9.
J Diabetes Investig ; 10(4): 1075-1082, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30548799

RESUMO

AIMS/INTRODUCTION: The aim of the present study was to examine the associations of pregestational body mass index (BMI) and gestational weight change with birthweight for gestational age in Japanese mothers with gestational diabetes mellitus (GDM). MATERIALS AND METHODS: We retrospectively examined the clinical and laboratory characteristics of 101 mothers with GDM (pregestational BMI 24.7 ± 5.8 kg/m2 ; maternal age at delivery 34.7 ± 5.1 years; gestational age 38.5 ± 1.4 weeks) at a single center from January 2011 to December 2016. RESULTS: Gestational weight changes were 6.22 ± 5.39 kg, and infant birthweights were 2,987.3 ± 393.6 g. Multivariable analysis showed that, in all mothers, pregestational BMI and gestational weight change were positively associated with infant birthweight (P < 0.001 and P = 0.007, respectively). Pregestational BMI, but not gestational weight change, was positively associated with infant birthweight (P = 0.007) in 31 mothers with GDM who had pregestational BMI ≥25 kg/m2 ; in 68 mothers with GDM who had pregestational BMI 18.5-24.9 kg/m2 , only gestational weight gain was positively associated with infant birthweight (P = 0.039). Two mothers had pregestational BMI <18.5 kg/m2 . No statistically significant interactions of pregestational BMI with gestational weight change were found (P = 0.158). CONCLUSIONS: In mothers with GDM, pregestational BMI ≥25 kg/m2 and excessive gestational weight gain were significantly associated with increased infant birthweight. A prospective multicenter clinical study enrolling a larger number of mothers with GDM will be required to verify the effects of adequately controlling pregestational and gestational weights on infant birthweight for gestational age.


Assuntos
Biomarcadores/análise , Peso ao Nascer , Índice de Massa Corporal , Diabetes Gestacional/fisiopatologia , Ganho de Peso , Adulto , Glicemia/análise , Diabetes Gestacional/sangue , Feminino , Seguimentos , Idade Gestacional , Hemoglobina A Glicada/análise , Humanos , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Fatores de Risco
10.
J Cancer Educ ; 34(6): 1059-1066, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30069808

RESUMO

The purpose of this study was to investigate the effect of the presence of visiting lecturer-guided class on children's knowledge of cancer prevention and perceptions of cancer patients, conducting surveys before and after the cancer education classes at local elementary schools that are pioneering cancer education. We implemented self-administered questionnaire surveys with 571 sixth-grade children at nine elementary schools receiving cancer education in the Tokyo metropolitan area from September 2013 to February 2014. The surveys were conducted twice in each classroom: 1 week before the cancer education class and 1 week after. The questionnaire items included participants' gender, cancer prevention information, and perceptions of cancer patients with the following description: "looks pitiful," "always depressed," "bedridden and hospitalized," "excessive smoking and drinking," "looks thin and pale," "no visible change despite cancer," and "always bright and cheerful." Children who had not attended the cancer education day, or had not completed both the pre- and post-test, were excluded from the analysis. Regardless of whether there visiting lecturer-guided class was provided, the possibility of improving children's knowledge of cancer prevention was demonstrated. On the other hand, in the post-class surveys, compared to the group with visiting lecturer-guided class, the group without it had a significantly lower percentage of persons selecting "Looks pitiful" (76.2%/63.5%, p = 0.002) and significantly higher percentages for "Too much smoking and drinking," and "Looks thin and pale" (50.2%/63.5%, p = 0.002; 18.8%/31.1%, p = 0.001). Therefore, study is needed into cancer education coordinated with relevant institutions in order to more effectively utilize visiting lecturers and the like.

13.
J Epidemiol ; 28(11): 470-475, 2018 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-29760321

RESUMO

BACKGROUND: There has been no nationwide analysis of travel time for hospital admission in Japan. Factors associated with travel time are also unknown. This study aimed to describe the distribution of travel time for hospital admission of cancer patients and identify underlying factors. METHODS: The individual data from the Patient Survey in 2011 were linked to those from the Survey of Medical Institutions in the same year, and GIS data were used to calculate driving travel time between the addresses of medical institutions and the population centers of municipalities where patients lived. Proportions of patients with travel time exceeding versus not exceeding 45 minutes were calculated. To analyze the data with consideration of both individual factors of patients and geographical characteristics of areas where patients lived, multilevel logistic model analysis was performed. RESULTS: The analysis included 50,845 cancer inpatients. The majority of the cancer patients (approximately 80%) were admitted to hospitals located less than a 45-minute drive from their residences. The travel time tended to be longer for younger patients. The proportion of patients with travel time ≥45 minutes was lower among those with stomach or colorectal cancer (approximately 15%) than those with cervical cancer or leukemia (approximately 30%). The lack of designated cancer care hospitals in the secondary healthcare service areas was significantly associated with travel time. CONCLUSIONS: Selection of hospitals by cancer inpatients is affected by age, cancer sites, and availability of designated cancer care hospitals in the secondary healthcare service areas where patients live.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Neoplasias/terapia , Características de Residência/estatística & dados numéricos , Viagem/estatística & dados numéricos , Adulto , Idoso , Conjuntos de Dados como Assunto , Feminino , Sistemas de Informação Geográfica , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Fatores de Tempo
16.
Cancer Sci ; 109(2): 422-434, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29178401

RESUMO

The present study aimed to compare cancer incidence and trends in survival for children diagnosed in Japan and England, using population-based cancer registry data. The analysis was based on 5192 children with cancer (age 0-14 years) from 6 prefectural cancer registries in Japan and 21 295 children diagnosed in England during 1993-2010. Differences in incidence rates between the 2 countries were measured with Poisson regression models. Overall survival was estimated using the Kaplan-Meier method. Incidence rates for Hodgkin lymphoma, renal tumors and Ewing sarcomas in England were more than twice as high as those in Japan. Incidence of germ cell tumors, hepatic tumors, neuroblastoma and acute myeloid leukemia (AML) was higher in Japan than in England. Incidence of all cancers combined decreased in Japan throughout the period 1993 to 2010, which was mainly explained by a decrease in registration of neuroblastoma in infants. For many cancers, 5-year survival improved in both countries. The improvement in survival in chronic myeloid leukemia (CML) was particularly dramatic in both countries. However, 5-year survival remained less than 80% in 2005-2008 in both countries for AML, brain tumors, soft tissue sarcomas, malignant bone tumors and neuroblastoma (age 1-14 years). There were significant differences in incidence of several cancers between countries, suggesting variation in genetic susceptibility and possibly environmental factors. The decrease in incidence for all cancers combined in Japan was related to the cessation of the national screening program for neuroblastoma. The large improvement in survival in CML coincided with the introduction of effective therapy (imatinib).


Assuntos
Neoplasias/epidemiologia , Adolescente , Neoplasias Ósseas/epidemiologia , Criança , Pré-Escolar , Inglaterra/epidemiologia , Doença de Hodgkin/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Japão/epidemiologia , Neoplasias Renais/epidemiologia , Sarcoma de Ewing/epidemiologia , Análise de Sobrevida
17.
18.
Jpn J Clin Oncol ; 47(11): 1097-1102, 2017 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-28977484

RESUMO

Objective: To estimate cumulative incidence and mortality risk for gastric cancer by risk category. Methods: Risk was classified into four types according to the presence/absence of Helicobacter pylori infection and chronic atrophic gastritis: in order of lowest to highest risk, Group A: H. pylori(-) and atrophic gastritis(-); Group B: H. pylori(+) and atrophic gastritis(-); Group C:H. pylori(+) and atrophic gastritis(+); and, Group D: H. pylori(-) and atrophic gastritis(+). We used vital statistics for the crude all-cause and crude gastric cancer mortality rates in 2011 and data from population-based cancer registries (the Monitoring of Cancer Incidence in Japan) for gastric cancer incidence in 2011. For relative risk and prevalence, we used the results of a meta-analysis integrating previous studies and data from the Japan Public Health Center-based Prospective Study for the Next Generation, respectively (baseline survey 2011-16). We calculated the crude incidence and mortality rates and estimated the cumulative risk using a life-table method. Results: The estimated lifetime cumulative incidence risk was 11.4% for men and 5.7% for women. The estimated risk for Groups A, B, C and D was 2.4%, 10.8%, 26.7% and 35.5% for men, and 1.2%, 5.5%, 13.5% and 18.0% for women, respectively. Similarly, the estimated lifetime cumulative mortality risk was 3.9% for men and 1.8% for women. The estimated risk of mortality for Groups A, B, C and D was 0.8%, 3.6%, 9.0% and 12.0% for men, and 0.4%, 1.7%, 4.2% and 5.7% for women, respectively. Conclusions: Our results may be useful for designing individually tailored prevention programs.


Assuntos
Neoplasias Gástricas/epidemiologia , Adulto , Idoso , Feminino , Gastrite Atrófica/complicações , Infecções por Helicobacter/complicações , Helicobacter pylori/isolamento & purificação , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Risco , Neoplasias Gástricas/etiologia , Neoplasias Gástricas/mortalidade
19.
20.
Cancer Sci ; 108(10): 2079-2087, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28746796

RESUMO

The preventive effect of coffee on cancer at different sites has been reported, but the effect on all-sites cancer incidence has not been extensively investigated. We evaluated the association between frequency of coffee consumption and risk of all-sites cancer incidence and mortality among 39 685 men and 43 124 women (age 40-79 years, at baseline), in the Three-Prefecture Cohort Study. The association between frequency of coffee consumption and risk of all-sites cancer incidence and mortality was assessed by a Cox proportional hazards regression model, adjusted for potential confounders. During 411 341 person-years among men and 472 433 person-years among women, a total of 4244 men and 2601 women developed cancer at different sites and a total of 3021 men and 1635 women died of cancer at different sites. We showed an inverse association between frequency of coffee consumption and all-sites cancer incidence in both men and women. Comparing participants who consumed coffee with those who never drank coffee, the adjusted hazard ratios (95% confidential interval) for all-sites cancer incidence was 0.74 (0.62-0.88) for coffee consumption of ≥5 cups/day in men (P for trend < 0.001) and 0.76 (0.58-1.02) in women (P for trend = 0.020). Coffee consumption frequency was inversely associated with mortality from all-sites cancer. In this population, increasing coffee consumption resulted in a decreased risk of all-sites cancer incidence and mortality.


Assuntos
Cafeína/administração & dosagem , Neoplasias/epidemiologia , Neoplasias/prevenção & controle , Adulto , Idoso , Cafeína/uso terapêutico , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Inquéritos e Questionários
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