Skip to main content
SpringerLink
Log in

Socioeconomic status and cancer screening in Japanese males: Large inequlaity in middle-aged and urban residents

  • Original Article
  • Published:
Environmental Health and Preventive Medicine Aims and scope

Abstract

Objectives

Cancer screening has become common in Japan. However, little is known about the socioeconomic factors affecting cancer screening participation. This study was performed to examine the association between socioeconomic status and cancer screening participation in Japanese males.

Methods

Using the data of 23,394 males sampled from across Japan, the associations between self-reported participation in screenings for three types of cancer (i.e., stomach, lung and colon) and socioeconomic variables, including marital status, types of residential area (metropolitan/nonmetropolitan), household income, and employment status, were examined using multilevel logistic regression by age group (40 to 64 and ≥65 years).

Results

The cancer screening participation rates were 34.5% (stomach), 21.3% (lung), and 24.8% (colon) for the total population studied. Being married, living in a nonmetropolitan area, having a higher income and being employed in a large-scale company showed independent associations with a higher rate of cancer screening participation for all three types of cancer. Income-related differences in cancer screening were more pronounced in the middle-aged population than in the elderly population, and in metropolitan areas than in nonmetropolitan areas.

Conclusions

There are notable socioeconomic differences in cancer screening participation in Japan. To promote cancer screening, socioeconomic factors should be considered, particularly for middle-aged and urban residents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Acheson D. Independent Inquiry into Inequalities in Health. London: Stationary Office; 2000.

    Google Scholar 

  2. Kogenvinas M, Pearce N, Susser M, Boffetta P. Social Inequalities and Cancer. Oxford: IARC; 1997.

    Google Scholar 

  3. Davey Smith G. Health Inequalities. Bristol: Policy Press; 2003.

    Google Scholar 

  4. Hsia J, Kemper E, Kiefe C, Zapka J, Sofaer S, Pettinger M, et al. The importance of health insurance as a determinant of cancer screening: evidence from the Women’s Health Initiative. Prev Med. 2003; 31: 261–270.

    Article  Google Scholar 

  5. Wu ZH, Black SA, Markides KS. Prevalence and associated factors of cancer screening: why are so many older Mexican American women never screened? Prev Med. 2003; 33: 268–273.

    Article  Google Scholar 

  6. Klassen AC, Smith ALM, Meissner HI, Zabora J, Curbow B, Mandelblatt J. If we gave away mammograms, who would get them? A neighborhood evaluation of a no-cost breast cancer screening programme. Prev Med. 2002; 34: 13–21.

    Article  PubMed  Google Scholar 

  7. Banks E, Beral V, Cameron R, Hogg A, Langley N, Barnes I, et al. Comparison of various characteristics of women who do and do not attend for breast cancer screening. Breast Can Res. 2002; 4: R1.

    Article  Google Scholar 

  8. Lorant V, Boland B, Humblet P, Deliege D. Equity in prevention and health care. J Epidemiol Community Health. 2002; 56: 510–516.

    Article  PubMed  CAS  Google Scholar 

  9. Baker D, Middleton E. Cervical screening and health inequality in England in the 1990s. J Epidemiol Community Health. 2003; 57: 417–423.

    Article  PubMed  CAS  Google Scholar 

  10. Suarez L, Ramirez AG, Villarreal R, Marti J, McAlister A, Talavera GA, et al. Social networks and cancer screening in four U.S. Hispanic groups. Am J Prev Med. 2000; 19: 47–52.

    Article  PubMed  CAS  Google Scholar 

  11. Hisamichi S. Community screening programmes of cancer and cardiovascular diseases in Japan. J Epidemiol. 1996; 6: S159-S163.

    PubMed  CAS  Google Scholar 

  12. Yamaguchi K. Overview of cancer control programmes in Japan. Jpn J Oncol. 2002; 32: S22-S31. (Article in Japanese)

    Article  Google Scholar 

  13. Ministry of Health, Labour and Welfare. Report of Community and Elderly Health. Tokyo: Health and Welfare Statistics Association; 2003. (Article in Japanese)

    Google Scholar 

  14. Yoshimura T. Occupational health. J Epidemiol. 1996; 6: S115-S120.

    PubMed  CAS  Google Scholar 

  15. Hamashima C, Yoshida K. What is important for the introduction of cancer screening in the workplace? Asia Pac J Can Prev. 2003; 4: 39–43.

    Google Scholar 

  16. Ministry of Health, Labour and Welfare. 2001 Comprehensive Survey of the Living Conditions of People on Health and Welfare. Tokyo: Health and Welfare Statistics Association; 2003. (Article in Japanese)

    Google Scholar 

  17. Mejer L, Siermann C. Income Poverty in the European Union: Children, Gender and Poverty Gaps. Luxembourg: Eurostat; 2000.

    Google Scholar 

  18. Hirata M, Kumagai S, Tabuchi T, Tainaka H, Ando T, Orita H. Actual conditions of occupational health activities in small-scale enterprises in Japan: system for occupational health, health management and demands by small-scale enterprises. Sangyo Eiseigaku Zasshi. 1999; 41: 190–201. (Article in Japanese)

    PubMed  CAS  Google Scholar 

  19. Okubo T. The present state of occupational health in Japan. Int Arch Occup Environ Health. 1997; 70: 148–152.

    Article  PubMed  CAS  Google Scholar 

  20. Leyland AH, Goldstein H. Multilevel Modelling of Health Statistics. West Sussex: Wiley; 2001.

    Google Scholar 

  21. Siahpush M, Singh GK. Sociodemographic predictors of pap test receipt, currency and knowledge among Australian women. Prev Med. 2002; 35: 362–368.

    Article  PubMed  Google Scholar 

  22. Chamot E, Perneger TV. Men’s and women’s knowledge and perceptions of breast cancer and mammography screening. Prev Med. 1999; 34: 380–385.

    Article  Google Scholar 

  23. Nijis HGT, Essink-Bot ML, DeKoning HJ, Kirkels WJ, Schroder FH. Why do men refuse or attend population-based screening for prostate cancer? J Public Health Med. 2000; 22: 312–316.

    Article  Google Scholar 

  24. Tanaka T, Tsushima S, Morio S, Okamoto N, Sato T, Kakigawa Y, et al. Analysis of cancer screening participation in regional inhabitants. Kosei no Shihyo. 1990; 37: 21–28. (Article in Japanese)

    Google Scholar 

  25. Morio S, Okamoto N, Tanaka T, Tsushima S, Sato T, Takigawa Y, et al. Participation of regional inhabitants in cancer screening. Nippon Koshu Eisei Zasshi. 1990; 37: 559–568. (Article in Japanese)

    PubMed  CAS  Google Scholar 

  26. Hirano Y, Ojima T. Analysis of factors influencing participation in the cervical cancer screening programme in the community in Japan. J Epidemiol. 1997; 7: 125–133.

    PubMed  CAS  Google Scholar 

  27. Ministry of Health, Labour and Welfare. Survey on Demands of Health and Welfare Services. Tokyo: Health and Welfare Statistics Association; 2000. (Article in Japanese)

    Google Scholar 

  28. Sackett DL. Bias in analytic research. J Chronic Dis. 1979. 32: 51–63.

    Article  PubMed  CAS  Google Scholar 

  29. Delgado-Rodriguez M, Llorca J. Bias. J Epidemiol Community Health. 2004; 58: 635–641.

    Article  PubMed  Google Scholar 

  30. Tsubono Y, Fukao A, Hisamichi S, Hosokawa T, Sugawara N. Accuracy of self-report for stomach cancer screening. J Clin Epidemiol. 1994; 47: 977–981.

    Article  PubMed  CAS  Google Scholar 

  31. Caplan LS, Mandelson MT, Anderson LA. Health Maintenance Organization: Validity of self-reported mammography: examining recall and covariates among older women in a Health Maintenance Organization. Am J Epidemiol. 2003; 57: 267–272.

    Article  Google Scholar 

  32. Armstrong K, Long JA, Shea JA. Measuring adherence to mammography screening recommendations among low-income women. Prev Med. 2004; 38: 754–760.

    Article  PubMed  Google Scholar 

  33. Watanabe Y, Morita M. Screening for gastric and colorectal cancer in Japan. Journal of Kyoko Prefectural University of Medicine. 2003; 112: 371–378. (Article in Japanese)

    Google Scholar 

  34. Ozasa K. Lung cancer screening, today. Journal of Kyoto Prefectural University of Medicine. 2003; 112: 395–402. (Article in Japanese)

    Google Scholar 

  35. Nakaya N, Ohmori K, Suzuki Y, Hozawa A, Kuriyama S, Tsubono Y, et al. A survey regarding the implementation of cancer screening among municipalities in Japan. Nippon Koshu Eisei Zasshi. 2004; 51: 530–539. (Article in Japanese)

    PubMed  Google Scholar 

  36. Galobardes B, Shaw M, Lawlor DA, Lynch JW, Davey Smith G. Indicators of socioeconomic position (part 1). J Epidemiol Community Health. 2006; 60: 7–12.

    Article  PubMed  Google Scholar 

  37. Kunst A, Mackenbach J. Measuring socioeconomic inequalities in health. Copenhagen: WHO Regional Office for Europe; 1997.

    Google Scholar 

  38. Ohtake F. Inequalities in Japan. Tokyo: Nihon Keizai Shinbunsha; 2005. (Article in Japanese)

    Google Scholar 

  39. Diez-Roux AV. Multilevel analysis in public health research. Annu Rev Public Health. 2000; 21: 171–192.

    Article  PubMed  CAS  Google Scholar 

  40. Subramanian SV, Jone K, Duncan C. Multilevel Methods for Public Health Research. In: Kawachi I, Berkman LF editors. Neighborhoods and Health. New York: Oxford University Press; 2003. p. 65–111.

    Google Scholar 

  41. Fukuda Y, Nakamura K, Takano T. Increased excess deaths in urban areas: quantification of geographical variation in mortality in Japan, 1973 to 1998. Health Policy. 2004; 68: 233–244.

    Article  PubMed  Google Scholar 

  42. Fukuda Y, Nakamura K, Takano T. Cause-specific mortality differences across socioeconomic position of municipalities in Japan, 1973–77 and 1993–98: increased importance of injury and suicide in inequality for ages under 75. Int J Epidemiol. 2005; 34: 100–109.

    Article  PubMed  Google Scholar 

  43. Fukuda Y, Nakamura K, Takano T. Accumulation of health risk behaviors is associated with lower socioeconomic status and women’s urban residence: a multilevel analysis in Japan. BMC Public Health. 2005; 5: 53.

    Article  PubMed  Google Scholar 

  44. Christenfeld N, Glynn LM, Phillips DP, Shrira I. Exposure to New York City as a risk factor for heart attack mortality. Psychosom Med. 1999; 61: 740–743.

    PubMed  CAS  Google Scholar 

  45. Ramachandran A, Snehalatha C, Latha E, Monaharan M, Vijay VI. Impacts of urbanization on the lifestyle and on the prevalence of diabetes in native Asian Indian population. Diabetes Res Clin Pract. 1999; 44: S207-S213.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Health Promotion/International Health, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan

    Yoshiharu Fukuda, Keiko Nakamura & Takehito Takano

  2. Department of Epidemiology, National Institute of Public Health, 2-3-6 Minami, 351-0197, Wako, Saitama, Japan

    Hiroyuki Nakao & Hirohisa Imai

Authors
  1. Yoshiharu Fukuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Keiko Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takehito Takano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroyuki Nakao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hirohisa Imai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yoshiharu Fukuda.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fukuda, Y., Nakamura, K., Takano, T. et al. Socioeconomic status and cancer screening in Japanese males: Large inequlaity in middle-aged and urban residents. Environ Health Prev Med 12, 90–96 (2007). https://doi.org/10.1007/BF02898155

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02898155

Key words

Search

Navigation