Warning: If you aren’t a healthcare worker or don’t want to read about poo, you may want to “move on” from this post. (Haha, see what I did there?)


Cancer rates in Japan are high—ridiculously high. Literature from the Japanese government tells us that one third of all deaths in Japan are from cancer, which they say is one of the highest levels in the world.

So, the Japanese government has chosen a proactive approach. Once people reach the age of 40, they’re urged to get screened for cancer every year. Our health cards even have a special section that reminds us to get tested for each of the “big five” cancers each year. They are:

  • stomach cancer
  • large intestinal cancer
  • lung cancer
  • breast cancer
  • uterine cancer

This year's health card, with the cancer screening section highlighted

Today, I thought I’d share with you our most recent cancer screening experience. Our tests for the first three cancers are scheduled for later this week, but before this happens there are preparations to complete. So I’ll write this blog in two parts:

  1. The Preparations
  2. The Testing Experience


Making the Appointment

Hospitals in Japan aren’t like hospitals in Canada. In Japan, they’re doctor-owned. When a group of doctors choose to build a hospital, they also decide on which specialities to include in their hospital. This means that not every hospital provides doctors of every specialty. 

Here are the specialties chosen by two real hospitals in Okinawa:

  • Hospital 1: paediatrics, neurosurgery, and gynaecology
  • Hospital 2: respiratory issues, paediatrics and dermatology

So, if you’re screening for a variety of cancers, you may have to travel a bit to get all of the necessary tests. 

In our case, we’re fortunate to have a hospital nearby that deals with stomachs, large intestines, and lungs, so Peter gets to have all his tests in one place. I have to travel to two additional places for the last two screenings.

The municipal government mails out cancer testing reminders every year. Along with the reminders, it includes helpful information on all of the local hospitals that are available to provide tests. 

After you call to book your appointment, the hospital will send you a package with all the materials you’ll require to prepare for your test day.


The Paperwork

As you can see, there’s a lot of paperwork to read and fill out.

Cancer Screening Paperwork

And all of it (apart from that one line about the gastroscopy) is in Japanese. So it takes a while to sift through.

Then there are the forms. One is a general health history. The other is more specific to a barium test we’ll be taking for stomach cancer screening. 

If we were also doing the scope test, there’s a third form for that. (We plan to alternate years for barium and scope tests.)


The Stool Sample

Then there’s the stool sample. Japanese doctors seem to love their stool samples!

Stool Sample Kit

Along with the paperwork comes a handy little kit, nicely packaged up in a dark green plastic baggie. Here are the contents:

  • exterior bag that will need to be labelled with name, gender, age, and the dates on which the samples were taken
  • instructions
  • two stool collection bottles
  • two paper collection aids

Here’s what the instructions look like:

Stool Sample Instructions

The pictures are pretty self-explanatory.

The one thing you might not catch on to is how the paper collection aid comes into play.

Basically, you’re supposed to unfold it and place it in the bowl of the toilet, to prevent the stool from sinking into the water. 

See?

Paper Aid

Yes, you’re seeing that right. There’s a literal bull’s eye target on the paper for where you’re supposed to aim!

Then you follow the rest of the instructions to collect the sample, snap the lid on the container shut, and flush everything down the toilet. (The paper is flushable.)

Samples are supposed to be taken on two consecutive days if possible, and stored in the fridge until your appointment.

And with the ick factor pretty much sky-high (for me, at least) I will end for now. 


UPDATE: The Experience

We were asked to arrive at the hospital at 8:30am. When we did, we handed over our stool samples, and were placed in a cohort with about 10 other people. This is the room where we each waited between the various stages of our testing.

Hospital waiting room: very comfortable!

First, we were asked to change out of our regular clothes, leaving our things in locked change room lockers. Here are pictures of us in our fancy hospital wear. You will notice that there are no gowns gaping at the back; everything is well-covered. 

Wearing the hospital gowns. Peter is clearly a better picture-taker than I am!

The nurses rotated through us, triaging, testing, and providing explanations of what would happen next. 

We ended up at the back of the pack. This seems pretty common in a healthcare setting. They know that we, as foreigners, are going to take a little longer to communicate. So in situations like this, when they’re trying to get through a slew of patients as quickly as possible, they thend to leave us until last so they can take whatever extra time is needed.

Everything went pretty smoothly, from the barium and lung x-rays to the rather lengthy health interview. 

One and a half weeks later, Peter received his results:

Peter’s test results, which came in the mail

For each test, he was categorized as “A”: no abnormal findings.

I just finished the last of this year’s screening tests yesterday, so I have a bit longer to wait for results.

But there you have it: cancer screening in Japan!