Abstract
BackgroundCancer prevention is a crucial challenge in preventive medicine. Several studies have suggested that voluntary health check-ups and recommendations from health professionals are associated with increased participation in cancer screening. In Japan, it is recommended that individuals aged 40–74 years should undergo annual health check-ups; however, the compliance to this recommendation is approximately <50%. According to the national survey, individuals who do not undergo annual health check-ups are at a higher risk for cancer. However, to the best of our knowledge, no previous study has investigated the association between the use of health check-ups and the incidence rate of cancer. We hypothesised that not undergoing periodic health check-ups and/or less use of outpatient medical services are predictors for advanced cancer.MethodsTo explore the relationship between health check-up or outpatient service utilisation and cancer incidence, this retrospective cohort study used data at two time points—baseline in 2014 and endpoint in 2017—from the National Health Insurance (NHI) claims and cancer registry. A multivariable logistic regression analysis was performed to investigate whether cancer diagnosis was associated with health check-up or outpatient service utilisation.ResultsA total of 72,171 participants were included in the analysis. The results of the multivariable logistic regression showed that individuals who skipped health check-ups had a higher risk of cancer diagnosis (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.04–1.40). Moreover, not undergoing health check-ups increased the risk of advanced-stage cancer (OR, 1.78; 95% CI, 1.29–2.44). Furthermore, increased rate of outpatient service utilisation was negatively associated with advanced cancer diagnosis.ConclusionsThis is the first study reporting that not undergoing health check-ups is a predictor of cancer diagnosis and advanced cancer stage. Primary prevention strategies for NHI members who do not undergo health check-ups must be reassessed. Moreover, future research should examine secondary prevention strategies, such as health education and recommendations from health professionals to facilitate adequate utilisation of preventive health services.Supplementary informationThe online version contains supplementary material available at https://doi.org/10.1265/ehpm.21-00292.
Highlights
Cancer prevention is a crucial challenge in preventive medicine
The present study explored whether abstinence from health check-ups or frequency of outpatient service utilisation are predictors of cancer incidence, through a retroactive analysis of National Health Insurance (NHI) and cancer registry data
The baseline characteristics of participants according to health check-up participation are shown in Additional file 3
Summary
Several studies have suggested that voluntary health check-ups and recommendations from health professionals are associated with increased participation in cancer screening. A multivariable logistic regression analysis was performed to investigate whether cancer diagnosis was associated with health check-up or outpatient service utilisation. Cancer is a leading cause of death in high-income countries; the national cancer registry of Japan reported that the total incidence of cancer in 2017 was 977,393 (558,869 male and 418,510 female) [1]. Previous studies suggest that secondary prevention strategies, including establishing continuous relationships with providers such as general practitioners [4,5,6], receiving recommendations from healthcare professionals, undergoing regular check-ups [7], increasing the frequency of visits to physicians [8, 9], and increasing contacts with healthcare professionals [10], were associated with increased cancer screening utilisation
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