Current status of and future outlook for cancer screening in Japan

A new healthcare service for the elderly began in Japan in 1983, with the national government subsidizing screening for stomach and uterine cancer. Following this, government subsidies were also introduced for lung, colon, and breast cancer screening. At that time, no other countries provided publicly funded cancer screening, and cancer screening in Japan spread more widely than in any other country in the world. However, the incorporation into general revenue of cancer screening costs in 1998 impacted cancer screening tremendously. As funding for cancer screening becomes increasingly vague, the number of people undergoing screening has diminished and concerns are held for the quality (accuracy) of screenings. In contrast, in Europe and the Unites States, cancer screening systems were created as a national policy beginning in the 1990s. Consequently, these screening systems are showing results. For example, in many countries the screening rate for breast cancer has reached a level of 50% or higher, and the breast cancer mortality rate has declined as a result. In contrast, the screening rate for breast cancer in Japan has remained at around 10%, and the breast cancer mortality rate continues to increase. In order to achieve two objectives - a significant increase in cancer screening rates and improvement of quality control - I propose that health insurers provide cancer screening for insured people.