Abstract
ObjectivesTo assess the impact of the quantity of resources for breast and cervical cancer screening on the participation rates in screening in clinical settings in municipalities, as well as to clarify whether lack of resources impairs access to cancer screening in Japan.MethodsOf the 1,746 municipalities in 2010, 1,443 (82.6%) and 1,469 (84.1%) were included in the analyses for breast and cervical cancer screening, respectively. In order to estimate the effects of the number of mammography units and of gynecologists on the participation rates in breast and cervical cancer screening in clinical settings, multiple regression analyses were performed using the interaction term for urban municipalities.ResultsThe average participation rate in screening in clinical settings was 6.01% for breast cancer, and was 8.93% for cervical cancer. The marginal effect of the number of mammography units per 1,000 women was significantly positive in urban municipalities (8.20 percent point). The marginal effect of the number of gynecologists per 1,000 women was significantly positive in all municipalities (2.54 percent point) and rural municipalities (3.68 percent point).ConclusionsLack of mammography units in urban areas and of gynecologists particularly in rural areas impaired access to breast and cervical cancer screening. Strategies are required that quickly improve access for the residents and increase their participation rates in cancer screening.
Highlights
The participation rates in breast and cervical cancer screening are lower in Japan than in Western countries
A systematic review of interventions to increase participation rates in cancer screening conducted by the United States Centers for Disease Control and Prevention (CDC) indicated that reducing the time and distance to access breast and colorectal cancer screening would be effective in increasing the participation rates [7,8]
The cancer screening programs in municipalities are implemented through mass surveys that are done for people at designated times in medical facilities and screening vans and screening in clinical settings for individuals by appointment in medical facilities
Summary
The participation rates in breast and cervical cancer screening are lower in Japan than in Western countries. The time and distance required to access cancer screening are viewed as factors that lower the participation rates in other countries as well [3,4,5,6]. The cancer screening programs in municipalities are implemented through mass surveys (mass screenings) that are done for people at designated times in medical facilities and screening vans (mobile screening units) and screening in clinical settings for individuals by appointment in medical facilities. Cancer screening in clinical settings was implemented to make it possible for people to participate in screening at a convenient time and in a desired nearby medical facility, in addition to the mass surveys [9]. The participation rate in screening in clinical settings among municipalities over the two-year period of 2012–2013 was only 18.8% and 25.5% for breast and cervical cancers, respectively [10]
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