Masayuki Tatemichi

Objective: To examine associations between occupation and overall and site-specific cancer risk in Japan. Methods: We conducted a multicenter, hospital-based matched case–control study using the Inpatient Clinico-Occupational Survey of the Rosai Hospital Group (2005–2023), including 146,994 cancer cases and 278,244 matched controls. Conditional logistic regression was used to estimate sex-specific adjusted odds ratios by occupations. Results: Occupational disparities in cancer risk were observed, with more pronounced associations among men than women. Elevated risks were identified in manual and transport-related occupations, whereas lower risks were observed in selected professional occupations. Site-specific patterns varied by cancer type and sex. Conclusions: Occupation is associated with cancer risk in Japan, showing distinct sex-specific and site-specific patterns. These findings underscore the importance of occupational context in cancer epidemiology and provide a hypothesis-generating framework highlighting behavioral and detection-related factors.

Background: Public awareness campaigns and testing promotion must be strengthened to eliminate infections with hepatitis B and C viruses (HBV and HCV, respectively) by 2030. Although public health campaigns using various forms of advertising are widely implemented, the most appropriate channels for viral hepatitis testing remain unclear. Objective: This study aims to identify web services and digital advertising channels appropriate for promoting HBV and HCV testing, segmented by prior testing history and the desire for hepatitis virus testing. Methods: A nationwide cross-sectional online survey of Japanese adults aged 20 to 69 years was conducted. The respondents answered questions regarding viral hepatitis testing status, routinely used web services (180 options), and exposure to digital advertising (25 options). Correspondence analysis was used to visualize relationships among testing segments, web services, and digital advertising. For individuals classified as “never having been tested and wishing to be tested,” channel-specific alignment was quantified using cosine θ. Sensitivity analyses were conducted by repeating the correspondence analysis after excluding respondents uncertain about their testing history and by fitting modified Poisson regression models with robust variance to estimate prevalence ratios and 95% CIs. Results: Of the 2000 respondents (1011 male and 989 female), 18% (n=359) reported prior HBV and HCV testing, and 22.1% (n=441) were unsure whether they had ever been tested. Web services characteristically associated with “never having been tested and wishing to be tested” included Lawson (convenience store: cosine θ =0.989) and Cosme (shopping: cosine θ =0.987). The corresponding digital advertising channels included in-store and storefront screens at Welcia (pharmacy chain: θ =0.994) and Lawson (cosine θ =0.937). Segment-specific patterns varied according to age group and sex. Sensitivity analyses excluding the unsure group showed similar patterns. Modified Poisson regression results were also consistent; for example, Lawson web service use was associated with a desire for hepatitis virus testing (prevalence ratio 1.75, 95% CI 1.22‐2.52). Conclusions: In Japan, the convenience store chain Lawson was a frequently used touchpoint, both online and offline, among individuals seeking viral hepatitis testing. Future studies are needed to determine whether implementing awareness-raising activities through Lawson can increase the uptake of testing and subsequent treatment.

Background: Although cancer screening is essential for early detection and an improved prognosis, screening beyond the recommended guidelines may increase the risk of false-positive results. Consequently, educating individuals about the potential harm of non–guideline-based cancer screening is essential; however, effective communication methods remain unclear. Objective: This study aimed to evaluate the effectiveness of different types of educational videos in encouraging preferences for guideline-based cancer screening. Methods: This 3-arm pseudorandomized controlled trial was conducted in June 2025 using a Japanese online survey platform. Eligible respondents were working adults aged 30 to 60 years with no history of major cancer. Respondents were assigned to 1 of the following 3 video conditions: video A, which provided a logical explanation of false-positive risks; video B, which presented the narrative of a woman who received a false-positive result from breast cancer screening; and video C, which depicted a man who underwent unnecessary follow-up testing after tumor marker screening. The primary outcome was the preference for guideline-based cancer screening after watching the videos. The secondary outcomes included 7 self-reported video evaluation items, such as perceived relevance and clarity, assessed using a 5-point Likert scale. Differences in the primary outcome between video groups were analyzed using multivariable logistic regression with adjustment for covariates. Means and 95% CIs were calculated for each secondary outcome according to sex and video group. In addition, before-and-after changes in screening preferences were assessed using McNemar test, with a significance level of .05. Results: In total, 1200 respondents (400 per group) completed the survey. No statistically significant differences in the primary outcome were observed among the video groups. With reference to video A, the adjusted odds ratios for preferring guideline-based screening were 0.89 (95% CI 0.59-1.32) for video B and 0.98 (95% CI 0.65-1.46) for video C. Regarding secondary outcomes, male respondents rated video B less favorably than female respondents in terms of relevance and willingness to undergo guideline-based screening. The before-and-after comparison showed a significant change in preference for guideline-based screening (P=.04). These videos appeared to be more effective for individuals with an annual history of colorectal cancer screening than for those without such a history. Conclusions: Educational videos have the potential to influence cancer screening preferences; however, no single video format has demonstrated clear superiority. These findings underscore the importance of tailoring educational materials to the target audience characteristics. Further research is required to develop effective strategies for encouraging guideline-based cancer screening. Trial Registration: University Hospital Medical Information Network Clinical Trials Registry UMIN000060549; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000066119

BACKGROUND Public awareness campaigns and testing promotion must be strengthened to eliminate infections with hepatitis B and C viruses (HBV and HCV, respectively) by 2030. Although public health campaigns using various types of advertising are widely conducted, the appropriate channels for viral hepatitis testing remain unclear. OBJECTIVE To identify web services and digital advertising channels appropriate for promoting HBV and HCV testing, segmented by prior testing history and testing intention. METHODS A nationwide cross-sectional online survey of Japanese adults aged 20–69 years was conducted. The respondents answered questions on viral hepatitis testing status, routinely used web services with 180 options, and exposure to digital advertising with 25 choices. Correspondence analysis was used to visualize the associations among the testing segments, web services, and digital advertising. The distinctiveness was quantitatively evaluated. RESULTS Of the 2000 respondents (1011 men, 989 women), 18.0% (359/2000) reported prior HBV and HCV testing, and 22.1% (441/2000) were unsure whether they had ever been tested. Web services characteristically associated with those who had never been tested but were willing to be tested included Lawson (convenience store) and cosme (cosmetic shopping). The corresponding digital advertising channels included in-store and storefront screens at Welcia (pharmacy chain) and Lawson (convenience store). Segment-specific patterns varied according to age group and sex. CONCLUSIONS In Japan, the convenience store chain Lawson was a distinctively frequent touchpoint, both online and offline, among individuals who wished to undergo viral hepatitis testing. Future studies are needed to determine whether implementing awareness-raising activities through Lawson can lead to an increased uptake of testing and subsequent treatment.

Background: The transtheoretical model (TTM) explains behavior changes through sequential stages influenced by the balance of perceived benefits and barriers. Although previous studies have identified the inhibitors and facilitators of exercise behavior, only a few have elucidated how these factors vary across the stages of behavior change. Objective: This study aimed to identify the inhibitors and facilitators of each stage of behavior change using text mining. Methods: A nationwide cross-sectional study was conducted using an internet-based questionnaire with a panel of approximately 2 million members. From this panel, 93,460 individuals were randomly selected and invited to participate via email and app push notifications. A total of 1500 valid responses were included in the analysis through stratified sampling based on sex, age group, and geographic region. The participants self-assessed their stages of change. Two open-ended questions captured the perceptions of inhibitors and facilitators of exercise behavior. Text responses were analyzed in a 4-step process: morphological analysis to extract frequently used words, correspondence analysis to visualize relationships between frequently used words and the 5 change stages, conceptual categorization with coding rules, and creation of heat maps to illustrate stage-specific categories in inhibitors and facilitators. Results: Out of 1500 respondents, 754 (50.3%) were males and 355 (23.7%) individuals were in the 50‐59 age group. Stage percentages were precontemplation 24.3% (), contemplation 23.5% (), preparation 21.3% (), action 5% (), and maintenance 25.9% (1500). The inhibitors and facilitators were described using 9893 words and 8372 words, respectively. Inhibitors clustered into 7 categories; most frequent were time (408/1500, 27.2%), motivation (253), health (189), and working (158). Facilitators formed 8 categories; most frequent were subjectivity (155), relationship (), opportunity (), reward (1500, 5.2%), and record (). Stage-specific patterns emerged: inhibitors shifted from motivation and health (precontemplation) to family, time, and working (contemplation and preparation), opportunity (action), and weather and health (maintenance). Facilitators of reward, health, and record rose progressively from precontemplation to maintenance. Conclusions: This study enhances our understanding of the dynamic mechanisms underlying exercise behavior change by identifying how specific inhibitors and facilitators vary across behavioral stages. The findings underscore the need to tailor interventions based on individuals’ readiness to change, rather than relying on one-size-fits-all strategies. For both practitioners and policymakers, incorporating behavioral stage frameworks into assessments and interventions, such as those conducted during health checkups or workplace programs, may improve the effectiveness and sustainability of physical activity promotion.

Objective: This study aimed to identify key performance indicators (KPIs) in workplace health promotion (WHP) and their associations with initiative performance, history, and industrial background. Methods: We conducted a cross-sectional study analyzing descriptions of KPIs from 2679 Japanese companies participating in government-led WHP initiatives. Text-mining techniques were used to categorize the KPIs and examine their association with company rankings, submission history, and industry. Results: Eleven KPIs were identified, including health status, productivity improvement, and recruitment. Productivity improvements and losses were frequently referenced by top-ranked companies, whereas lower-ranked companies and new participants prioritized recruitment and retention, which were commonly discussed in the retail, healthcare, and welfare industries. Mental health was more prevalent in the information, technology, communication, and electrical equipment sectors. Conclusions: The findings support effective KPI setting in WHP and provide insights to inform dissemination of government-led initiatives.

BACKGROUND Although cancer screening is essential for early detection and an improved prognosis, screening beyond the recommended guidelines may increase the risk of false-positive results. Consequently, educating individuals about the potential harm of non–guideline-based cancer screening is essential; however, effective communication methods remain unclear. OBJECTIVE This study aimed to evaluate the effectiveness of different types of educational videos in encouraging preferences for guideline-based cancer screening. METHODS This 3-arm pseudorandomized controlled trial was conducted in June 2025 using a Japanese online survey platform. Eligible respondents were working adults aged 30 to 60 years with no history of major cancer. Respondents were assigned to 1 of the following 3 video conditions: video A, which provided a logical explanation of false-positive risks; video B, which presented the narrative of a woman who received a false-positive result from breast cancer screening; and video C, which depicted a man who underwent unnecessary follow-up testing after tumor marker screening. The primary outcome was the preference for guideline-based cancer screening after watching the videos. The secondary outcomes included 7 self-reported video evaluation items, such as perceived relevance and clarity, assessed using a 5-point Likert scale. Differences in the primary outcome between video groups were analyzed using multivariable logistic regression with adjustment for covariates. Means and 95% CIs were calculated for each secondary outcome according to sex and video group. In addition, before-and-after changes in screening preferences were assessed using McNemar test, with a significance level of .05. RESULTS In total, 1200 respondents (400 per group) completed the survey. No statistically significant differences in the primary outcome were observed among the video groups. With reference to video A, the adjusted odds ratios for preferring guideline-based screening were 0.89 (95% CI 0.59-1.32) for video B and 0.98 (95% CI 0.65-1.46) for video C. Regarding secondary outcomes, male respondents rated video B less favorably than female respondents in terms of relevance and willingness to undergo guideline-based screening. The before-and-after comparison showed a significant change in preference for guideline-based screening (P=.04). These videos appeared to be more effective for individuals with an annual history of colorectal cancer screening than for those without such a history. CONCLUSIONS Educational videos have the potential to influence cancer screening preferences; however, no single video format has demonstrated clear superiority. These findings underscore the importance of tailoring educational materials to the target audience characteristics. Further research is required to develop effective strategies for encouraging guideline-based cancer screening. CLINICALTRIAL University Hospital Medical Information Network Clinical Trials Registry UMIN000060549; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000066119

BACKGROUND The transtheoretical model (TTM) explains the behavioral changes through sequential stages influenced by the balance of perceived benefits and barriers. Although prior studies have identified the inhibitors and facilitators of exercise behavior, only few have elucidated how these factors vary across the stages of behavioral change. OBJECTIVE This study aimed to identify the inhibitors and facilitators of each stage of behavioral change using text mining. METHODS A survey was conducted among 1,500 Japanese adults aged 20–69 years, recruited through stratified sampling based on sex, age group, and geographical region. The participants self-assessed their stages of change. Two open-ended questions captured the perceptions of inhibitors and facilitators of exercise behavior. Text responses were analyzed in a four-step process: morphological analysis to extract frequently used words, correspondence analysis to visualize relationships between frequently used words and the five change stages, conceptual categorization with coding rules, and creation of heat maps to illustrate stage-specific categories in inhibitors and facilitators. RESULTS The respondents included 754 males and 355 individuals in the 50–59 age group. Among them, 356 and 388 were in the precontemplation and maintenance stages, respectively. The inhibitors and facilitators were described using 9,893 words and 8,372 words, respectively. The inhibitors were categorized into seven groups: motivation, health, weather, family, time, opportunity, and working. The facilitators were classified into eight categories: reward, subjectivity, opportunity, relationship, health, record, digital device, and time. The stage-specific inhibitors included motivation and health in precontemplation; family, time, and working in contemplation and preparation; opportunity in action; and weather and health in maintenance. Facilitators, such as reward, health, and record, increasingly contributed as individuals progressed from precontemplation to maintenance. CONCLUSIONS The findings of this study provide quantitative insights into the dynamics of inhibitors and facilitators across TTM stages. The inhibitors were low motivation, health issues, lack of time due to poor work–life balance, limited opportunities, and adverse weather conditions, which need to be sequentially addressed to acquire exercise habits. Recording personal progress and providing rewards for health improvements and consistency gradually emerged as facilitators. Intervention strategies targeting these inhibitors and facilitators can serve as effective new approaches for sustainable exercise habits.

Objectives While there is growing evidence that physical activity reduces the risk of hepatocellular carcinoma (HCC), the impact of occupational physical activity and sedentary behaviour remains unclear. This study aimed to investigate the associations between occupational physical activity and sedentary behaviour and HCC risk. Design Matched case-control study. Setting Nationwide multicentre, hospital-inpatient data set in Japan, from 2005 to 2021. Participants The study included 5625 inpatients diagnosed with HCC and 27 792 matched controls without liver disease or neoplasms. Participants were matched based on sex, age, admission date, and hospital. Primary measures The association between levels of occupational physical activity (low, medium, high) and sedentary time (short, medium, long) with the risk of HCC. Secondary measures Stratification of HCC risk by viral infection status (hepatitis B/C virus), alcohol consumption levels and the presence of metabolic diseases (hypertension, diabetes, dyslipidaemia, obesity). Results High occupational physical activity was not associated with HCC caused by hepatitis B/C virus infection in men. In women, high occupational physical activity was associated with a reduced risk of non-viral HCC, with ORs (95% CIs) of 0.65 (0.45–0.93). Among patients with non-viral HCC, medium occupational physical activity combined with medium alcohol intake further decreased the HCC risk in men with an OR of 0.70 (0.50–0.97), while high occupational physical activity combined with lowest alcohol intake decreased the HCC risk in women with an OR of 0.69 (0.48–0.99). Men and women with medium sedentary time had a lower HCC risk compared with those with long sedentary time, with ORs of 0.88 (0.79–0.98) in men and 0.77 (0.62–0.97) in women, respectively. In patients without viral infection or alcohol use, medium sedentary time reduced the HCC risk associated with fatty liver disease without comorbid metabolic diseases in women. Conclusions High levels of occupational physical activity and/or medium periods of sedentary time are associated with a reduced risk of HCC, particularly non-alcoholic steatohepatitis.

Objective In this study, we aimed to structure motivation for workplace health promotion (WHP) and explore the relationship between motivation and WHP performance. Methods We qualitatively categorized the WHP motivations written on the Health Productivity and Management (HPM) survey sheet in Japan. We then quantitatively analyzed the relationship between the categories and their HPM rankings using multiple logistic regression. Results Responses from 2003 companies were analyzed. The WHP motivations were summarized into 12 categories. Higher-ranked companies more frequently mentioned corporate impressions, workplace environments, employee productivity, employee autonomy, and system management and less often mentioned recruitment and retention. Conclusions For more effective WHPs, companies need to support their current workforce, set specific goals, and allocate resources in the appropriate direction, such as increasing work engagement. Export