Breast Cancer Screening Behavior among Working Women in Japan: Characteristics and Factors Inhibiting Screening.

Background: Improving breast cancer screening rates is crucial for early detection. However, factors hindering regular screening among working women remain unclear. This study aimed to clarify screening behavior among working women in Japan and associated discouraging factors. Methods: Surveys were conducted from April to May 2019 among women aged 40-60 at public offices and companies in Tottori Prefecture. We used two surveys: the "Basic Attributes Questionnaire" and the "Structural Questionnaire on Rejecting Screening." Data analysis involved chi-squared tests, logistic regression analysis, factor analysis, and nonparametric tests. Results: Completed questionnaires analyzed were 668 out of 825 collected (response rate: 81.0%). Most participants were part-time employees with an average age of 51 years. Over 60% reported undergoing regular screening. Logistic regression analysis identified part-time employment, lack of children, a discouraging workplace atmosphere, and absence of personal connections to breast cancer patients as factors associated with avoiding breast cancer screening. Factor analysis identified five factors and 16 items as reasons for not undergoing regular screening. Women who had no spouse, no children or felt that their workplace was not encouraging breast screening felt difficulty in scheduling screening most strongly. Conclusion: Individuals who had part-time employment and had no children, did not know a breast cancer patient, or considered that their workplace environment was not supportive were more likely to avoid undergoing regular breast cancer screening. Also, women who did not undergo regular screening experienced difficulty in scheduling. In the future, the challenge lies in disseminating accurate knowledge about breast cancer to foster awareness without excessive anxiety.

[Questionnaire Survey of Radiation Protection Education in Hospitals].

PURPOSE: The present study aimed to investigate the current situation of radiation protection education for designated radiation workers in hospitals. METHODS: A web-based questionnaire survey was conducted at 1,883 hospitals nationwide with 200 or more beds. RESULTS: Responses from 186 hospitals were included in the analysis. Seven hospitals (6.7%) regulated by the Act on the Regulation of Radioisotopes and six hospitals (7.4%) regulated by only the Ordinance on Prevention of Ionizing Radiation Hazards did not implement radiation protection education. In approximately 6% of the hospitals, designated radiation workers-including physicians, nurses, and radiological technologist-did not attend the education program. The education program attendance rate of physicians was lower than that of nurses. In more than 90% of the hospitals, the frequency of the periodical education program was once every year and lecture time spanned one or less than one hour. The topics of lecture in more than 90% of the hospitals were health effects of radiation and methods of radiation protection for occupational exposure. The radiological technologist was the instructor of the education program in approximately 70% of the hospitals. CONCLUSION: The implementation of radiation protection for designated radiation workers varied from hospital to hospital, and some hospitals did not comply with laws and regulations. Effective and efficient radiation protection education models should be implemented in hospitals.

Factors associated with response to compression-based physical therapy for secondary lower limb lymphedema after gynecologic cancer treatment: a multicenter retrospective study.

BACKGROUND: Lower limb lymphedema (LLL) is one of the most refractory and debilitating complications related to gynecological cancer treatment. We investigated factors associated with response to compression-based physical therapy (CPT) for secondary LLL after gynecologic cancer treatment. METHODS: We performed a multicenter retrospective study using the records of seven medical institutions from 2002 and 2014. Patients who developed LLL after gynecological cancer treatment were included. Limb volumes were calculated from the lengths of the limb circumferences at four points. All participants underwent compression-based physical therapy for LLL. Factors, including MLD, indicative of circumference reductions in LLL were determined. RESULTS: In total, 1,034 LLL met the required criteria of for the study. A multivariate linear regression analysis identified age; body mass index (BMI); endometrial cancer; radiotherapy; and initial limb circumference as significant independent prognostic factors related to improvement in LLL. In analysis of covariance for improvement in LLL adjusted by the initial limb circumference and stratified by BMI and radiotherapy, patients with BMI 28 kg/m2 or higher and receiving radiation rarely responded to CPT. CONCLUSIONS: Improvements in the lower limb circumference correlated with clinical histories and physical characteristics, which may be used as independent prognostic factors for successful CPT for LLL after gynecological cancer treatment.

Risk factors for late-onset lower limb lymphedema after gynecological cancer treatment: A multi-institutional retrospective study.

INTRODUCTION: Late-onset lower limb lymphedema (LLL) is a significant clinical challenge for physicians dealing with patients that undergo treatment involving the pelvic cavity. We aimed to clarify the prevalence of and risk factors for late-onset LLL after treatment for gynecological cancer. METHODS: We conducted a multicenter retrospective study using records of cases in which LLL diagnosed by physical findings and measurement of limbs girths. Patients with LLL after treatment for uterine cervical, endometrial, and ovarian cancer were sequentially enrolled. We examined the timing of LLL onset and the associations between the time to onset and clinical characteristics, including age, type of cancer, lymphadenectomy sites, and performance of radiotherapy. We also investigated the risk factors for late-onset LLL and their effects on the cumulative incidence of late-onset LLL. RESULTS: In total, 711 patients fulfilled the required criteria. Mean age of was 50.2 years old and median follow-up period was 5.05 years. More than half of them (50.5%) presented with LLL ≥5 years after undergoing treatment for gynecological cancer. A substantial number of patients (29.4%) developed LLL ≥10 years after undergoing treatment for gynecological cancer. Being aged <50 years [(odds ratio (OR): 1.919, P = 0.001), cervical cancer (OR: 1.912, P = 0.001), and radiotherapy (OR: 1.664, P = 0.017) were identified as significant risk factors for late-onset LLL in multivariate logistic regression analysis. CONCLUSIONS: A substantial number of patients present with LLL ≥5 years after receiving treatment for gynecological malignancies. Clinicians are required to identify high-risk patients and inform them of the risk of late-onset LLL.

Physiological characteristics of the body fluid in lymphedematous patients postbreast cancer surgery, focusing on the intracellular/extracellular fluid ratio of the upper limb.

AIM: The aim of this research was to determine the physiological characteristics of patients with lymphedema following breast cancer surgery, based on differences between the quantity of body water in the right and left fingertips, with a view to establishing whether or not this simple measurement could serve as a predictive index for the onset of lymphedema. METHOD: The research was conducted at a hospital in Hiroshima, Japan (August 2004 to December 2004). Observations were made on 39 female breast cancer patients who had undergone surgery and 45 healthy female participants. Additional information was collected via interviews with the individual participants. The quantity of body water in all the participants was measured by using a bioimpedance spectrum analysis system. Comparisons of the intracellular/extracellular fluid ratios (I/Es) were made between the edema patients and the non-edema patients, with further testing being done between the affected and unaffected sides of the upper limb in the edema patients. RESULTS: In the edema patients, significant differences were recognized between the affected side's upper limb I/E and the unaffected side's upper limb I/E. In relation to the affected side's upper limb I/E of the edema patients, even when the mean value and standard deviation were included, the value did not exceed 1.0 and the mean - 3 SD value of the affected side's upper limb I/E in the non-edema patients was 1.04. CONCLUSIONS: The results suggest that measurements of the affected and unaffected sides' upper limb I/E showed a potential for use as a reliable predictive index for lymphedema.

Comparison of the body fluid levels in healthy individuals and those with schizophrenia in Japan: using the bioelectrical impedance method.

Polydipsia and water intoxication have been found to be care problems in people with schizophrenia in many countries. This Japanese study measured the body fluid distribution and body fat of 80 males with long standing schizophrenia and compared this to that of 64 healthy males, using bioelectrical impedance spectrum analysis (BIS). Participants with schizophrenia exhibited significantly lower percentages of intracellular fluid and total body fluid, and significantly higher percentages of fat. Moreover, the percentage of extracellular fluid was distributed over a wider range. When the percentage body fluid was compared between the two groups by matching body mass index and body fat, intracellular fluid was significantly lower for those participants with schizophrenia. There findings suggest that nurses and other health professionals need to be very cautious when attempting to modify the excessive drinking of fluids by patients with schizophrenia. In mistakenly trying to prevent water intoxication, they may in fact be contributing to dehydration.