Screening here is arranged by the city or ward you live in. If the Japanese in what they send out is beyond you, it is hard to tell which screening is being offered, whether you are on the list this year, or what will be done on the day.
Two schemes matter here if you are a woman in her forties or beyond, and they are separate things. Breast screening is part of cancer screening, which follows national guidance. Bone screening is a scheme of its own, with its own list of ages.
Our guide to menopause treatment quotes the medical society on both: keep up breast cancer screening for as long as you are on HRT, and osteoporosis is among the conditions HRT is credited with heading off. Neither said how to actually get screened here.
Neither is screening for menopause. There is no such thing here. Seeing a doctor because symptoms are troubling you is a different thing again. That is an ordinary consultation, and our guide to menopause treatment in Japan sets out what insurance covers.
Breast screening starts at 40
Cancer screening is run by your municipality, meaning your city or ward, under the Health Promotion Act. For breast cancer it is offered to women aged 40 and over who live there, as a rule once every two years.
The guideline adds an upper band to that. Women from 40 to 69 are the ones it says to recommend it to particularly. Above 69 you are still covered, and the guideline tells cities to take care that the opportunity is offered to you as well.
The guideline does not leave attendance entirely to you. Where someone did not attend the previous year, it tells cities to encourage attendance actively, and to make sure an opportunity exists every year. It does not say how they should do that, so whether anything reaches you by post is your own city's decision.
The ministry's guideline for cities lists two items: questions, and a mammogram. It then says plainly that visual inspection and palpation are not recommended. Where they are carried out anyway, it says they must be done alongside the mammogram rather than in place of it. So if you are expecting someone to examine you by hand as well, the guideline does not ask for that.
If you are 40 to 49, the mammogram is taken from two directions rather than one. The questions do not have to be asked face to face either; the guideline allows a form you fill in yourself to stand in for them.
Bone screening runs on seven fixed ages
This one is not cancer screening and does not appear on the same list. It sits in the ministry's guidelines for health promotion work, and the wording of who it covers is precise: women living in the city who are 40, 45, 50, 55, 60, 65 or 70.
骨粗鬆症検診 · The ages at which bone screening is offered. Women only, at five-year steps from 40 to 70. Source: Ministry of Health, Labour and Welfare, guidelines for health promotion work.
Every fifth birthday from 40 to 70, and the list is women only. The reason the ministry gives is that osteoporosis is an underlying condition for fractures and similar problems, and that cases are expected to rise as the population ages. The scheme exists to find reduced bone mass early. Menopause is not mentioned anywhere in it.
It runs, as a rule, once a year for the same person. There are two parts: questions covering exercise habits and what you eat, and a measurement of bone mass, carried out by CXD, DIP, SXA, DXA, pQCT or ultrasound among others.
Results come back in one of three bands, set by the ministry's osteoporosis prevention manual: 異常なし, no abnormality; 要指導, guidance required; and 要精検, further examination required.
Two of them lead to something further. If your result is 要指導, you are given advice on diet and exercise, and told about local health programmes on changing daily habits. If it is 要精検, you are told to go to a medical institution for a detailed examination.
Where your screening comes from
Screening reaches people in more than one way. The cancer information service splits it into three: screening your city runs for residents, screening an employer or an insurer runs, and screening you arrange yourself.
The ages and intervals above belong to the first of those. The national guidance is written for cities, so if your screening comes through work, what is included is not set by it.
What it costs, and who to ask
You are not paying the full price. Breast screening is part of cancer screening, and on that the health ministry is clear: most cities meet much of the cost from public funds, so you pay only part of it.
What that part comes to is set locally and changes, so the only reliable figure is the one your own city or ward gives you. For bone screening we could not find a national statement on cost at all, which makes your city the only place to ask.
Your city decides the rest too: whether anything is posted to you, whether you have to apply, and where the screening happens. The office to ask is the one where you live.
Sources
- Ministry of Health, Labour and Welfare, がん予防重点健康教育及びがん検診実施のための指針 (annex to notice 健発第0331058号, 31 March 2008, as amended, in Japanese): who breast screening covers, how often, and what it consists of
- Ministry of Health, Labour and Welfare, がん検診 (in Japanese): municipalities as the providers under the Health Promotion Act, and the cost
- National Cancer Center Japan, Cancer Information Service, がん検診について (in Japanese): the three routes screening reaches people by
- Ministry of Health, Labour and Welfare, 健康増進事業実施要領, 第３ 3 骨粗鬆症検診 (in Japanese): the aim, who is covered, what the screening involves, how often, and how results are classified
- Japan Society for Menopause and Women's Health, ホルモン補充療法の正しい理解をすすめるために (2023, in Japanese): quoted in our guide to menopause treatment in Japan
This page explains how screening is organised in Japan. It is not medical advice, and nothing here replaces a conversation with a doctor.