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在日企中,遵守国家结直肠癌、乳腺癌和宫颈癌筛查指南的情况:基于调查的企业实践分类为“过度筛查”、“不足筛查”和“指南遵循筛查”。

Adherence to national guidelines for colorectal, breast, and cervical cancer screenings in Japanese workplaces: a survey-based classification of enterprises' practices into "overscreening," "underscreening," and "guideline-adherence screening".

机构信息

Department of Comprehensive Radiation Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.

Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.

出版信息

BMC Public Health. 2024 Aug 15;24(1):2223. doi: 10.1186/s12889-024-19775-1.

Abstract

BACKGROUND

Workplace cancer screening programs are determined as part of an employee's benefits package and health checkups are perceived positively. However, the current status of workplace cancer screening programs in Japan is unavailable. This study aimed to assess the adherence to national guidelines for colorectal, breast, and cervical cancer screenings in the workplace among Japanese enterprises and identify factors associated with excessive or inadequate screenings.

METHODS

A cross-sectional study design was employed. Data were obtained from a survey conducted by the "Corporate Action to Promote Cancer Control" between November and December 2022 among registered partner enterprises in Japan. The survey included questions on background characteristics, cancer screening practices, and intervention approaches. The analysis included 432 enterprises that provided complete responses regarding colorectal, breast, and cervical cancer screenings.

RESULTS

The guideline-adherence rates for colorectal, breast, and cervical cancer screenings in the workplace were 12.7%, 3.0%, and 8.8%, respectively. Enterprises had lower adherence to screening guidelines than local governments. Colorectal (70.8%) and breast (67.1%) cancer screenings were predominantly categorized as "overscreening" and cervical (60.6%) cancer screening, as "underscreening." Factors such as enterprise scale, health insurance associations, and the number of interventional approaches were significantly associated with increased "overscreening" (101-1000: β = 0.13, p = 0.01; ≥ 1000: β = 0.17, p < 0.01; health insurance association: β = 0.23, p < 0.01; and approaches: β = 0.42, p < 0.01) and reduced "underscreening" (101-1000: β = -0.13, p = 0.01; ≥ 1000: β = -0.17, p < 0.01; health insurance association: β = -0.18, p < 0.01; and approaches: β = -0.48, p < 0.01).

CONCLUSION

Adherence to national guidelines for colorectal, breast, and cervical cancer screenings in the workplace was suboptimal among Japanese enterprises. Therefore, appropriate cancer screening measures and interventions to ensure guideline adherence and optimization of screening benefits while minimizing potential harms should be expeditiously implemented.

摘要

背景

职场癌症筛查计划被确定为员工福利套餐的一部分,且健康检查受到积极认可。然而,目前日本职场癌症筛查计划的现状尚不清楚。本研究旨在评估日本企业对国家结直肠癌、乳腺癌和宫颈癌筛查指南的依从情况,并确定与过度或不足筛查相关的因素。

方法

采用横断面研究设计。数据来自于 2022 年 11 月至 12 月期间“企业采取行动促进癌症控制”对日本注册合作伙伴企业进行的调查。该调查包括背景特征、癌症筛查实践和干预措施的问题。分析纳入了 432 家完整回答了结直肠癌、乳腺癌和宫颈癌筛查问题的企业。

结果

职场结直肠癌、乳腺癌和宫颈癌筛查的指南依从率分别为 12.7%、3.0%和 8.8%。企业对筛查指南的依从性低于地方政府。结直肠癌(70.8%)和乳腺癌(67.1%)筛查主要被归类为“过度筛查”,宫颈癌(60.6%)筛查则被归类为“不足筛查”。企业规模、医疗保险协会和干预措施数量等因素与“过度筛查”显著相关(101-1000:β=0.13,p=0.01;≥1000:β=0.17,p<0.01;医疗保险协会:β=0.23,p<0.01;干预措施:β=0.42,p<0.01),与“不足筛查”显著相关(101-1000:β=-0.13,p=0.01;≥1000:β=-0.17,p<0.01;医疗保险协会:β=-0.18,p<0.01;干预措施:β=-0.48,p<0.01)。

结论

日本企业职场结直肠癌、乳腺癌和宫颈癌筛查对国家指南的依从性不理想。因此,应迅速采取适当的癌症筛查措施和干预措施,以确保指南的依从性,并优化筛查效益,同时最大限度地减少潜在危害。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6e6/11325713/6e612991d61d/12889_2024_19775_Fig1_HTML.jpg

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