著者

Daisuke Hori Tsukasa Takahashi Yudai Kaneda Akihiko Ozaki Takahiro Tabuchi

出版者

The Japanese Society for Hygiene

雑誌

Environmental Health and Preventive Medicine (ISSN:1342078X)

巻号頁・発行日

vol.28, pp.10, 2023 (Released:2023-02-02)

参考文献数

20

被引用文献数

5

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Background: Before the COVID-19 vaccine became available, many Japanese people were undecided about whether or not to receive them. Their decisions were keys to achieving herd immunity. The impact of the type of information source on the COVID-19 vaccine uptake decision-making process remains unclear. We aimed to investigate the association between information source usage on COVID-19 and subsequent vaccine uptake status among those who have yet to decide whether to receive vaccines from non-prioritized people for vaccination.Methods: Prospective cohort online self-administered surveys were conducted in February 2021 (T1), before the start of the mass vaccination program, and September–October 2021 (T2), when the vaccines were available to all citizens. The survey’s target population was registered monitors of an Internet research company. Participants who answered “I want to get vaccinated after waiting to see how it goes.” at T1 were eligible for analysis. The outcome variable was the COVID-19 vaccine uptake status in T2, and the predictors were 20 types of information sources, categorized based on people (family members, etc.), institutions (governments, etc.), or media (TV news, etc.). Adjusted odds ratio and 95% confidence intervals were estimated using logistic regression adjusted for possible confounders.Results: The 5,139 respondents, mean age and standard deviation was 42.8 ± 12.5, 55.7% female, were eligible for analysis. 85.7% completed vaccination (including reserved/intended people) in T2. In the multivariate logistic analysis, odds ratios (95% confidence interval) for vaccine uptake were 1.49 (1.18–1.89) for workplaces/schools, 1.81 (1.33–2.47) for LINE, 0.69 (0.55–0.86) for Internet news and 0.62 (0.48–0.82) for video sharing sites.Conclusions: The type of information source usage played an important role in the decision to vaccinate against COVID-19. Although caution is needed in interpreting the results, obtaining information from workplaces/schools and LINE was influential in promoting immunization.

著者

Michikazu Nakai Yoshitaka Iwanaga Yoko Sumita Tetsuya Amano Ikuo Fukuda Tomoyasu Hirano Mami Iida Kota Katanoda Yoshihiro Miyamoto Masakazu Nakamura Keijiro Saku Takahiro Tabuchi Hiroshi Yamato Bo Zhang Hisayoshi Fujiwara

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0191, (Released:2023-08-22)

参考文献数

19

被引用文献数

1

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Background: Hyogo Prefecture has managed smoking ban legislation with partial restrictions in public places (Hyogo-L) since 2013. Previous studies have reported a significant decrease in admissions for acute coronary syndrome (ACS) in Kobe-city, but not in other districts of Hyogo Prefecture in the 2 years after Hyogo-L. The aim of the present study was to define the long-term effect of Hyogo-L.Methods and Results: The JROAD-DPC dataset was used to collect information on the number of hospitalizations for ACS in Hyogo Prefecture, and in Osaka-city without smoking ban legislation, from April 2013 to March 2020. Poisson regression analysis was performed to calculate incident rate ratios (IRRs) and 95% confidence intervals (CIs). ACS records of 3,101 in Kobe-city, 11,375 in areas of Hyogo Prefecture other than Kobe-city and 11,079 in Osaka-city were collected for admissions. The incidence of ACS reduced significantly over time in Kobe-city [IRR (95% CI); 0.96 (0.94–0.97)], but did not reduce in the others. The decrease in Kobe-city was observed in ACS patients without smoking, hypertension, and hyperlipidemia, but not in those with such risk factors.Conclusions: The long-term ACS reduction or non-reduction under Hyogo-L was determined at the initial period and the same scenario continued, supporting the importance of legislation and compliance with the smoking ban. The lowering effect was remarkable in ACS patients without risk factors such as non-smoking.

著者

Takahiro Tabuchi Sho Fujihara Tomohiro Shinozaki Hiroyuki Fukuhara

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20170163, (Released:2018-05-19)

参考文献数

38

被引用文献数

11

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Background: Our objective in this study was to find determinants of high-school dropout in a deprived area of Japan using longitudinal data, including socio-demographic and junior high school-period information.Methods: We followed 695 students who graduated the junior high school located in a deprived area of Japan between 2002 and 2010 for 3 years after graduation (614 students: follow-up rate, 88.3%). Multivariable log-binomial regression models were used to calculate the prevalence ratios (PRs) for high-school dropout, using multiple imputation (MI) to account for non-response at follow-up.Results: The MI model estimated that 18.7% of students dropped out of high school in approximately 3 years. In the covariates-adjusted model, three factors were significantly associated with high-school dropout: ≥10 days of tardy arrival in junior high school (PR 6.44; 95% confidence interval [CI], 1.69–24.6 for “10–29 days of tardy arrival” and PR 8.01; 95% CI, 2.05–31.3 for “≥30 days of tardy arrival” compared with “0 day of tardy arrival”), daily smoking (PR 2.01; 95% CI, 1.41–2.86) and severe problems, such as abuse and neglect (PR 1.66; 95% CI, 1.16–2.39). Among students with ≥30 days of tardy arrival in addition to daily smoking or experience of severe problems, ≥50% high-school dropout rates were observed.Conclusions: Three determinants of high-school dropout were found: smoking, tardy arrival, and experience of severe problems. These factors were correlated and should be treated as warning signs of complex behavioral and academic problems. Parents, educators, and policy makers should work together to implement effective strategies to prevent school dropout.

著者

Ai Hori Takahiro Tabuchi Naoki Kunugita

出版者

The Japanese Society for Hygiene

雑誌

Environmental Health and Preventive Medicine (ISSN:1342078X)

巻号頁・発行日

vol.28, pp.5, 2023 (Released:2023-01-18)

参考文献数

25

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Background: Heated tobacco product (HTP) use has increased substantially between 2016 and 2017 in Japan. This study aims to clarify how HTP use (IQOS, Ploom, and glo) spread across the different combustible cigarette smoking statuses during 2015–16 and 2017–18 in Japan.Methods: We compared the two periods of (i) 2015 to 2016 (N = 5,366) and (ii) 2017 to 2018 (N = 3,422) from a longitudinal study randomly sampling members from the Japan “Society and New Tobacco” Internet Survey (JASTIS). Multivariable logistic regression models for current HTP use in the previous 30 days by combustible cigarette smoking status in the previous year were used adjusting for socio-demographic factors.Results: HTP use increased by 10 times in the 2017–18 cohort compared with the 2015–16 cohort according to the adjusted odds ratio (95% confidence interval) for current HTP use as 10.2 (7.03–14.8). According to smoking status, significantly higher adjusted ORs (95% CIs) of current HTP use for the after period were observed: 2.60 (1.37–4.94) for never smokers, 7.82 (3.64–16.8) for former smokers, 21.1 (5.73–77.9) for current smokers with intention to quit, and 17.0 (9.58–30.3) for current smokers without intention to quit.Conclusion: During 2015 to 2018 in Japan, HTP use dramatically increased in all subgroups except for never smokers.

著者

Shihoko Koyama Takahiro Tabuchi Sumiyo Okawa Takayoshi Kadobayashi Hisaya Shirai Takeshi Nakatani Isao Miyashiro

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200533, (Released:2021-03-20)

参考文献数

51

被引用文献数

3 32

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Background: In April 2020, the Japanese government declared a state of emergency due to the COVID-19 pandemic, and infection control measures, including requests to work from home and stay-at-home restrictions, were introduced. This study examined changes in smoking behavior during the COVID-19 state of emergency.Methods: An online cross-sectional survey was conducted in Osaka, Japan. To assess differences in smoking behavior among 5,120 current smokers before and after the declaration of a state of emergency, prevalence ratios (PRs) for two outcomes, increased smoking and quitting smoking, were calculated using multivariable Poisson regression, adjusting for potential covariates.Results: We found 32.1% increased the number of cigarettes smoked and 11.9% quit smoking. After adjustment for all variables, we found risk factors for COVID-19 (men and older age group) had both significantly higher PR for quitting smoking (men: PR 1.38; 95% confidence interval [CI], 1.17–1.62) and participants aged ≥65 years: PR 2.45; 95% CI, 1.92–3.12) and significantly lower PR of increased smoking (men: PR 0.85; 95% CI, 0.78–0.93 and participants ≥65 years: PR 0.38; 95% CI, 0.29–0.49). Additionally, respondents working from home or living alone had significantly higher PR for increased smoking (working from home: PR 1.29; 95% CI, 1.17–1.41 and living alone: PR 1.23; 95% CI, 1.10–1.38) and respondents who changed from cigarettes to heated tobacco products (HTPs) had significantly lower PR for quitting smoking (PR 0.150; 95% CI, 0.039–0.582).Conclusions: We suggest people who have high-risk factors for COVID-19 might change their smoking behavior for the better, while people who work from home or live alone might change their smoking behavior for the worse, during the COVID-19 state of emergency. Additionally, changing from smoking cigarettes to using HTPs makes smokers less likely to quit.

著者

Tetsutaro Matayoshi Takahiro Tabuchi Iwao Gohma Takahiro Shimizu

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.82, no.12, pp.2941-2942, 2018-11-24 (Released:2018-11-24)

参考文献数

9

被引用文献数

3

著者

Takahiro Tabuchi Hiroyasu Iso Eric Brunner

出版者

日本疫学会

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20160206, (Released:2017-11-18)

参考文献数

32

被引用文献数

13

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Previous systematic reviews of population-level tobacco control interventions and their effects on smoking inequality by socioeconomic factors concluded that tobacco taxation reduce smoking inequality by income (although this is not consistent for other socioeconomic factors, such as education). Inconsistent results have been reported for socioeconomic differences, especially for other tobacco control measures, such as smoke-free policies and anti-tobacco media campaigns. To understand smoking inequality itself and to develop strategies to reduce smoking inequality, knowledge of the underlying principles or mechanisms of the inequality over a long time-course may be important. For example, the inverse equity hypothesis recognizes that inequality may evolve in stages. New population-based interventions are initially primarily accessed by the affluent and well-educated, so there is an initial increase in socioeconomic inequality (early stage). These inequalities narrow when the deprived population can access the intervention after the affluent have gained maximum benefit (late stage). Following this hypothesis, all tobacco control measures may have the potential to reduce smoking inequality, if they continue for a long term, covering and reaching all socioeconomic subgroups. Re-evaluation of the impact of the interventions on smoking inequality using a long time-course perspective may lead to a favorable next step in equity effectiveness. Tackling socioeconomic inequality in smoking may be a key public health target for the reduction of inequality in health.

著者

Yusaku MORITA Koji KANDABASHI Shigeyuki KAJIKI Hiroyuki SAITO Go MUTO Takahiro TABUCHI

出版者

National Institute of Occupational Safety and Health

雑誌

Industrial Health (ISSN:00198366)

巻号頁・発行日

pp.2022-0012, (Released:2022-05-11)

被引用文献数

2

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This study evaluated the relationship between occupational injuryrisk and gig work, which included the exchangeof labor for money between individuals or companies via digital platforms. AsJapan has experienced a severe economic decline during the coronavirus disease2019 (COVID-19) pandemic, an increasing number of individuals have engaged ingig work. While few studies have evaluated occupational risks in gig work, severaltraffic accidents associated with food delivery work have been reported in themass media. In this study, 18,317 individuals completed an internet survey thatcollected information pertaining to their involvement in gig work andexperience of related occupational injuries; data regarding several confounding factors were also recorded. Multiplelogistic regression analysis showed that workersinvolved in gig work had a greater risk of any minor occupational injuries(odds ratio, 3.40; 95% confidenceinterval, 2.81–4.11) and activity-limiting injuries (odds ratio, 8.37; 95% confidenceinterval, 6.47–10.82) than those not involved in gig work, after adjusting for age,sex, household income, lifestyle factors, and work-related factors. The resultsof this study indicate that gig workers are exposed to greater occupationalhazards during the COVID-19 pandemic. Additional studies are warranted toclarify the causal mechanism for this relationship.

著者

Mami Wakabayashi Hirono Ishikawa Yoshiharu Fukuda Hiroyasu Iso Takahiro Tabuchi

出版者

The Japanese Society for Hygiene

雑誌

Environmental Health and Preventive Medicine (ISSN:1342078X)

巻号頁・発行日

vol.28, pp.24, 2023 (Released:2023-04-18)

参考文献数

41

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Background: Little is known about the vulnerable populations and problem drinking in terms of health inequality. This study aimed to investigate the relationship between health indifference estimated by Health Interest Scale (HIS) and problem drinking identified by the Alcohol Use Disorder Identification Test (AUDIT).Methods: A cross-sectional study was conducted utilizing data from a nationwide internet survey in Japan in 2022. The number of total participants was 29,377, with 49% of them being male, and the mean age was 47.9 (±17.9) years. The participants were categorized into the following groups based on the quintiles of HIS score: health indifference (0–16), low health interest (17–20), middle health interest (21–22), middle-high interest (23–26) and high health interest (27–36) groups. Problem drinking was identified as AUDIT score of ≥8 points.Results: The association between health indifference and problem drinking was explored through logistic regression with adjustment for various socioeconomic status, such as education, income level, and occupation; the adjusted odds ratio (aOR) was 1.72 [95% confidence interval (CI): 1.51–1.95].Conclusion: Health indifferent or lower health interest groups were a vulnerable population for problem drinking, regardless of their socioeconomic status. It could be useful to identify the health indifferent group through HIS and to monitor the impact of health intervention for this group for the reduction of health inequality.

著者

Masao Ichikawa Takahiro Tabuchi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.7, pp.354-356, 2022-07-05 (Released:2022-07-05)

参考文献数

5

著者

Satomi Odani Tomohiro Shinozaki Kenji Shibuya Takahiro Tabuchi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.4, pp.195-203, 2022-04-05 (Released:2022-04-05)

参考文献数

31

被引用文献数

9

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Background: Coronavirus disease 2019 (COVID-19) has disproportionately affected the most vulnerable populations. We assessed the prevalence and disparities of economic hardships and their impact on health deterioration in Japan.Methods: Data were obtained from a nation-wide, cross-sectional, internet-based, self-reported survey conducted during August–September, 2020 with individuals aged 15–79 years in Japan (n = 25,482). Economic hardships and changes in various physical and mental health status were measured using sample-weighted data. Adjusted prevalence ratios (APRs) were estimated to investigate the associations between economic hardships and health outcomes.Results: During April–September, 2020 in Japan, 25.0%, 9.6%, 7.9%, and 3.1% of the respondents experienced income loss, money shortage, financial anxiety and financial exploitation, respectively, with higher prevalence among workers (vs non-workers). Stratifying by sex and working status, income loss was associated with physical health deterioration (APRs ranged from 1.45–1.95), mental health deterioration (APRs ranged from 1.47–1.68), and having serious psychological distress (APRs ranged from 1.41–2.01) across all strata. Shortage of money and financial anxiety were also associated with increased likelihood of all adverse health outcomes assessed, regardless of whether the hardships were pre-existing or experienced first time. Among non-working individuals, financial exploitation was associated with physical health deterioration among males (APR 1.88) and mental health deterioration among both males (APR 1.80) and females (APR 2.23), while such associations were not observed among working individuals.Conclusions: During the early phase of the COVID-19 epidemic, COVID-19-related economic hardships were associated with physical and mental health deterioration in Japan, particularly among the vulnerable populations. Timely and prompt responses are warranted to mitigate both economic and health burdens.

著者

Yoshihiko Hosokawa Sumiyo Okawa Ai Hori Naho Morisaki Yoko Takahashi Takeo Fujiwara Shoji F. Nakayama Hiromi Hamada Toyomi Satoh Takahiro Tabuchi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.4, pp.188-194, 2022-04-05 (Released:2022-04-05)

参考文献数

31

被引用文献数

45

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Background: Reluctance of people to receive recommended vaccines is a growing concern, as distribution of vaccines is considered critical to ending the COVID-19 pandemic. There is little information regarding pregnant women’s views toward coronavirus vaccination in Japan. Therefore, we investigated the vaccination rate and reasons for vaccination and vaccine hesitancy among pregnant women in Japan.Methods: We conducted a cross-sectional study involving 1,791 pregnant women using data from the Japan “COVID-19 and Society” Internet Survey, conducted from July to August 2021, and valid response from 1,621 respondents were analyzed. We defined participants with vaccine hesitancy as those who identified with the statement “I do not want to be vaccinated” or “I want to ‘wait and see’ before getting vaccinated.” Multivariate Poisson regression analysis was used to investigate the factors contributing to vaccine hesitancy.Results: The prevalence of vaccination and vaccine hesitancy among pregnant women was 13.4% (n = 217) and 50.9% (n = 825), respectively. The main reasons for hesitancy were concerns about adverse reactions and negative effects on the fetus and breastfeeding. Vaccine hesitancy was significantly associated with the lack of trust in the government (adjusted prevalence ratio, 1.26; 95% confidence interval, 1.03–1.54). Other factors, such as age, educational attainment, and state of emergency declaration, were not associated with vaccine hesitancy.Conclusions: COVID-19 vaccination is not widespread among pregnant women in Japan, although many vaccines have been shown to be safe in pregnancy. Accurate information dissemination and boosting trust in the government may be important to address vaccine hesitancy among pregnant women.

著者

Masao Ichikawa Takahiro Tabuchi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.1, pp.57-59, 2022-01-05 (Released:2022-01-05)

参考文献数

10

被引用文献数

1

著者

Yusaku MORITA Koji KANDABASHI Shigeyuki KAJIKI Hiroyuki SAITO Go MUTO Takahiro TABUCHI

出版者

National Institute of Occupational Safety and Health

雑誌

Industrial Health (ISSN:00198366)

巻号頁・発行日

vol.60, no.4, pp.360-370, 2022-05-11 (Released:2022-08-01)

被引用文献数

2

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This study evaluated the relationship between occupational injury risk and gig work, which included the exchange of labor for money between individuals or companies via digital platforms. As Japan has experienced a severe economic decline during the coronavirus disease 2019 (COVID-19) pandemic, an increasing number of individuals have engaged in gig work. While few studies have evaluated occupational risks in gig work, several traffic accidents associated with food delivery gig work have been reported in the mass media. In this study, 18,317 individuals completed an internet survey that collected information pertaining to their involvement in gig work and experience of related occupational injuries; data regarding several confounding factors were also recorded. Multiple logistic regression analysis showed that workers involved in gig work had a greater risk of any minor occupational injuries (odds ratio, 3.68; 95% confidence interval, 3.02–4.49) and activity-limiting injuries (odds ratio, 9.11; 95% confidence interval, 7.03–11.8) than those not involved in gig work, after adjusting for age, sex, household income, lifestyle factors, and work-related factors. The results of this study indicate that gig workers are exposed to greater occupational hazards during the COVID-19 pandemic. Additional studies are warranted to clarify the causal mechanism for this relationship.

著者

Naoki SHIOTA Tomohiro ISHIMARU Makoto OKAWARA Yoshihisa FUJINO Takahiro TABUCHI

出版者

National Institute of Occupational Safety and Health

雑誌

Industrial Health (ISSN:00198366)

巻号頁・発行日

vol.60, no.3, pp.216-223, 2021-10-15 (Released:2022-06-01)

被引用文献数

5

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This study aimed to evaluate the association between work-related changes caused by COVID-19 and psychological distress among Japanese workers. The cross-sectional study was conducted from August 25 to September 30, 2020. The participants were 15,454 employees who were registered as panelists with an online survey company. The Kessler psychological distress scale with a 13-point cutoff was used to measure psychological distress. Multiple logistic regression was performed. Of the respondents, 8.9% were evaluated as having severe psychological distress. Among five examined work-related changes, being laid off and changing jobs (adjusted odds ratio [aOR] = 5.43; 95% confidence interval [CI]: 4.18–7.05), experiencing temporary workplace closure (aOR = 1.94; 95% CI: 1.67–2.25), being forced to visit the workplace for paperwork (aOR = 1.84; 95% CI: 1.58–2.15), and starting telework from home (aOR = 1.18; 95% CI: 1.01–1.37) were associated with increased psychological distress; no significant association was found for participation in work-related online meetings. The impact on psychological distress was greater among men, especially for being laid off and changing jobs because of COVID-19. It is important to assess and reduce negative mental health effects among workers experiencing work-related changes caused by the COVID-19 pandemic, taking gender differences into account.

著者

Yuri Yaguchi-Tanaka Takahiro Tabuchi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.7, pp.417-425, 2021-07-05 (Released:2021-07-05)

参考文献数

34

被引用文献数

2 8

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Background: Few longitudinal studies have examined the association between skipping breakfast and overweight/obesity in pre-elementary school children. Furthermore, this association may differ between boys and girls. The main objective of this study was to assess whether skipping breakfast in early childhood was associated with later incidence of overweight/obesity, with stratification by gender, using data on children aged 2.5 to 13 years old in The Longitudinal Survey of Newborns in the 21st century.Methods: We examined the associations between skipping breakfast at 2.5 years old and overweight/obesity at 2.5 (n = 34,649), 4.5 (n = 35,472), 7 (n = 31,266), 10 (n = 31,211), and 13 (n = 28,772) years old. To estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of overweight/obesity by each age (2.5, 4.5, 7, 10, and 13 years), a multivariate logistic regression was used adjusting for time-invariant and time-varying covariates.Results: At the age of 2.5 years, 11.0% of boys and 12.2% of girls were skipping breakfast. In fully adjusted models, skipping breakfast at 2.5 years old was not significantly associated with overweight/obesity at 2.5 and 4.5 years old, but was significantly associated with overweight/obesity at 7 and 10 years old, in both sexes. Skipping breakfast at 2.5 years old was significantly associated with overweight/obesity at 13 years old in boys (OR 1.38; 95% CI, 1.17–1.62), but not in girls (OR 1.21; 95% CI, 0.98–1.49).Conclusions: Skipping breakfast in early childhood increased overweight/obesity in later childhood, but there may be gender differences in the association.

著者

Masao Ichikawa Haruhiko Inada Ai Hori Takahiro Tabuchi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.7, pp.451-452, 2021-07-05 (Released:2021-07-05)

参考文献数

3

被引用文献数

2

著者

Yukari Isaka Ai Hori Takahiro Tabuchi Sumiyo Okawa Masao Ichikawa

出版者

National Center for Global Health and Medicine

雑誌

GHM Open (ISSN:2436293X)

巻号頁・発行日

vol.1, no.1, pp.38-39, 2021-08-29 (Released:2021-09-01)

参考文献数

6

被引用文献数

1

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Home-visit services are provided to families with newborns as means of parenting support. These services potentially are playing major roles during the coronavirus disease 2019 (COVID-19) pandemic, where people have been socially isolated. However, the pandemic has deterred the use of this service to some extent. From the Japan "COVID-19 and Society" Internet Survey, we identified that 15% of the survey respondents who delivered between January 2020 and October 2020 refused home visit services. The proportion of the services used during the pandemic (85%) was lower than those used before the pandemic (95%). Home-visit services provide a unique opportunity for public health nurses to assess the risk of postpartum depression and child maltreatment in the family; thus, families with newborns should be instructed to receive home-visit services as well as child immunization and health checkups, despite the continuation of the pandemic.

著者

Daisuke Shigemi Toshitaka Morishima Ayako Shibata Takahiro Tabuchi Hideo Yasunaga Isao Miyashiro

出版者

Society for Clinical Epidemiology

雑誌

Annals of Clinical Epidemiology (ISSN:24344338)

巻号頁・発行日

vol.2, no.3, pp.75-83, 2020 (Released:2020-07-01)

参考文献数

28

被引用文献数

1

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BACKGROUNDUnlike the recommendations made in many other countries, Japanese guidelines equally recommend radical hysterectomy or concurrent chemoradiotherapy for treatment of stage IIB cervical carcinoma. The main study objective was to compare the overall mortality of hysterectomy versus concurrent chemoradiotherapy as primary treatment in patients with localized or regionally extended cervical cancer.METHODSUsing Diagnosis Procedure Combination database combined with population-based cancer registry data in Osaka Prefecture, Japan, we conducted a retrospective cohort study. All adult patients who had been diagnosed with cervical cancer, registered in the population-based cancer registry from January 1, 2010 to December 31, 2015 were included. To compare overall mortality between patients who received radical hysterectomy and concurrent chemoradiotherapy as primary treatment, we performed a Cox regression analysis of the original cohort, and Kaplan-Meier analysis with stabilized inverse probability of treatment weights using propensity score.RESULTSAmong 740 eligible patients, 564 patients were included in the hysterectomy group and 176 patients were included in the concurrent chemoradiotherapy group. Primary hysterectomy was not independently associated with overall mortality (adjusted HR 0.70, 95% CI 0.46–1.07) by the Cox regression analysis. The Kaplan-Meier analysis with stabilized inverse probability of treatment weights did not show a significant difference in overall mortality between the two groups (P = 0.096).CONCLUSIONSThis study indicates that primary treatment type (hysterectomy versus concurrent chemoradiotherapy) was not statistically associated with overall mortality among patients diagnosed with localized or regionally extended cervical cancer.

著者

Yuiko Nagamine Takeo Fujiwara Yukako Tani Hiroshi Murayama Takahiro Tabuchi Katsunori Kondo Ichiro Kawachi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.30, no.11, pp.497-502, 2020-11-05 (Released:2020-11-05)

参考文献数

36

被引用文献数

8

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Background: Socioeconomic mobility affects health throughout the life course. However, it is not known whether there are gender differences in the association between life-course subjective socioeconomic status (SSS) mobility and mortality at older ages.Methods: Participants were 16,690 community-dwelling adults aged 65–100 years in the Japan Gerontological Evaluation Study (JAGES). Baseline information including demographic characteristics, depression, and lifestyle factors were collected in 2010. Participants’ vital status was confirmed in 2013 via linkage to death records. We categorized life-course socioeconomic mobility into the following categories: ‘persistently high’, ‘downward mobility’, ‘upward mobility’, and ‘persistently low’. Cox proportional hazard modeling was used to estimate hazard ratios (HR) for all-cause mortality.Results: Mortality HRs for the ‘downward’ group were 1.37 (95% confidence interval [CI], 1.08–1.74) among men and 1.27 (95% CI, 0.94–1.71) among women in comparison with the ‘persistently high’ group. Compared to the ‘persistently low’ group, the HRs for the ‘upward’ group were 0.54 (95% CI, 0.35–0.83) among women and 0.91 (95% CI, 0.73–1.24) among men. Associations were not changed after adjusting for objective socioeconomic status but were attenuated by depression.Conclusions: ‘Downward’ mobility was associated with mortality among men, but not among women. Depression appeared to mediate the association. A protective effect of upward mobility was observed among women but not among men.