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Medical screening system for osteoporosis is important method for detection of osteopenia or osteoporosis in the community. The medical screening for osteoporosis was done for female subjects at age 40, 45, 50, 55, 60, 65, 70 year-old people according to the Health Promotion Act in Japan. The number of females received the screening was 287,782 in 2008, and the number corresponded to 4.7% of the estimated numbers of subjects for the screening in the population. Sixty six percentages of institutions measured bone mass and/or bone mineral density with the purpose other than that proposed by Health Promotion Act at 2009. Calcaneus bone mass was measured in 81% of institutions by quantitative ultrasound(QUS). Because QUS is inexpensive, involves no radiation exposure, and is easily portable, this method should be suitable for medical screening for osteoporosis and its prevalent use in Japan supports this assumption.

TB mass screening for elementary and junior-high school pupils was revised in 2003 in Japan. Interview sheet with questionaires about past history of TB and BCG has been applied for all pupils to choose high risk groups for TB infection or TB diseases since 2003 April replacing previous mass-screening method with tuberculin test for first-grade pupils. We compare results of case-finding of school-children in 2001, 2002 and 2003 by the data of national TB surveillance system. Total number of latent TB infection (LTBI) subjected to preventive treatment decreased from 2920 (2001), 2173 (2002) to 1087 (2003). Number of LTBI detected by school mass-examination decreased markedly from 1310, 933 to 99. In addition, two peaks of LTBI in 6-7 years old and 12-13 years old children disappeared. Number of LTBI by contact examination gradually decreased from 881, 742 to 687. Number of LTBI detected by medical facilities also decreased from 199, 121 to 76. Total number of TB patients among school-children also decreased from 122, 72 to 46. TB patients found by school mass-examination showed a marked decrease from 23, 21, to 6. TB patients detected by medical facilities decreased from 68, 29 to 19. Number of TB cases detected by the contact examinations did not change. The reduction in the number of LTBI and disappearance of two peaks in 6-7 years old and 12-13 years old children are assumed to be mainly due to the revision of TB mass screening method in elementary and junior-high schools.

Anti-cancer measures in Japan were started in the 1950s, and programs for the early detection of stomach and cervical cancer supported by the National Government were begun in 1966 and 1967, respectively. In 1983 the Health and Medical Services Law for the Elderly was enacted, and under this law nationwide early detection programs for stomach and cervical cancer have been under taken and the number of people screened has been steadily increasing. Accuracy control programs for these cancer detection systems are now being established by prefectural governments. The examination of programs for the early detection of lung cancer and breast cancer will be necessary when suitable methods have been established.

Due to the gradual increase of endometrial cancer, mass screening for this type of cancer began from 1987 in Japan in accordance with the Law of Health for the Elderly. However, a screening system for endometrial cancer has many controversial problems when compared with that for cervix cancer. Criteria for screening, methods of screening, management after screening, and executive systems are all controversial points in the performance of mass screening. The actual condition in the detection of endometrial cancer in Fukuoka Prefecture based on a questionnaire is discussed in this paper.

Since Japan, a national cancer control program has been initiated in 1957. The fundamental principles were set up in 1965. Under these principles, the Ministry of Health and Welfare granted financial support for stomach and uterine cancer mass screening programs, which were conducted by the local governments. At that time, the number of examinees was limited; 990,000 persons for stomach cancer screening program and 127,000 persons for uterine cancer screening program in 1966. However, it increased rapidly year after year and reached to 4,350,000 examinees for the stomach cancer and 2,656,000 examinees for the uterine cancer In 1983, the Health Promotion Act for the Aged was enacted. The Act prescribes the local municipalities to conduct stomach and uterine cancer mass screening programs for their inhabitants. This report describes a historical review of the development of the mass screening programs, especially on the objection objection against the programs in 1967-69 and in 1978-79, and on the reaction to those objection. The definition of mass screening programs and the future of mass screening are discussed.