Watanabe Kazuhiko, Tabuchi Takahiro, Zaitsu Masayoshi
Center for Research of the Aging Workforce, University of Occupational and Environmental Health, Japan, Kitakyushu, Fukuoka, Japan.
Division of Epidemiology, School of Public Health, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.
J Occup Health. 2025 Jan 7;67(1). doi: 10.1093/joccuh/uiaf046.
Cancer screening is crucial for early detection and improved health outcomes. Limited evidence exists on the association between occupational class and cancer screening participation in Japan. Therefore, we aimed to examine screening participation rates and disparities among active workers across different occupational classes.
This cross-sectional study analyzed data from a nationwide web-based survey conducted in Japan (September to November, 2023). Eligible participants included current workers aged 40-64 years for colorectal, lung, and stomach cancer screenings (n = 7038); workers aged 40-64 years for breast cancer screening (n = 2929); and workers aged 30-64 years for cervical cancer screening (n = 4252). Cancer screening participation rates across occupational classes (upper nonmanual, lower nonmanual, and manual workers) were compared using the chi-square test. Poisson regression with robust variance was used to estimate prevalence ratios (PRs) and 95% CIs for nonparticipation, adjusted for sex, age, educational attainment, household income, and workplace scale. Upper nonmanual workers served as the reference group.
Manual workers consistently had lower cancer screening participation rates. Compared with upper nonmanual workers, manual workers exhibited significantly higher PRs for nonparticipation in colorectal (PR = 1.12; 95% CI, 1.04-1.22), lung (PR = 1.22; 95% CI, 1.12-1.34), stomach (PR = 1.14; 95% CI, 1.05-1.23), and cervical cancer screenings (PR = 1.16; 95% CI, 1.02-1.33). The disparities were particularly pronounced among male workers.
Manual workers had lower cancer screening participation rates, particularly for colorectal, lung, stomach, and cervical cancer. Targeted interventions are needed to improve screening, particularly among manual workers, and reduce occupational disparities in cancer prevention and outcomes.
癌症筛查对于早期发现和改善健康结局至关重要。关于日本职业阶层与癌症筛查参与率之间的关联，现有证据有限。因此，我们旨在研究不同职业阶层在职员工的筛查参与率及差异。
这项横断面研究分析了在日本（2023年9月至11月）进行的一项全国性网络调查数据。符合条件的参与者包括年龄在40 - 64岁的在职员工，用于结直肠癌、肺癌和胃癌筛查（n = 7038）；年龄在40 - 64岁的女性员工用于乳腺癌筛查（n = 2929）；年龄在30 - 64岁的女性员工用于宫颈癌筛查（n = 4252）。使用卡方检验比较不同职业阶层（非体力劳动者上层、非体力劳动者下层和体力劳动者）的癌症筛查参与率。采用稳健方差的泊松回归来估计未参与筛查的患病率比（PRs）及95%置信区间（CIs），并对性别、年龄、教育程度、家庭收入和工作场所规模进行了调整。非体力劳动者上层作为参照组。
体力劳动者的癌症筛查参与率一直较低。与非体力劳动者上层相比，体力劳动者在结直肠癌（PR = 1.12；95% CI，1.04 - 1.22）、肺癌（PR = 1.22；95% CI，1.12 - 1.34）、胃癌（PR = 1.14；95% CI，1.05 - 1.23）和宫颈癌筛查（PR = 1.16；95% CI，1.02 - 1.33）中未参与筛查的PRs显著更高。这些差异在男性员工中尤为明显。
体力劳动者的癌症筛查参与率较低，尤其是在结直肠癌、肺癌、胃癌和宫颈癌筛查方面。需要有针对性的干预措施来改善筛查情况，特别是在体力劳动者中，并减少癌症预防和结局方面的职业差异。
