{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:39:25Z","timestamp":1787017165939,"version":"build-2736575974"},"reference-count":14,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T00:00:00Z","timestamp":1691712000000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ministry of Health, Labor, and Welfare, Japan","award":["20EA1017"],"award-info":[{"award-number":["20EA1017"]}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["22ck0106778h0001"],"award-info":[{"award-number":["22ck0106778h0001"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,7,20]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The COVID-19 pandemic led to an increase in mortality in most countries in 2020, deviating from prior decreasing trends. In Japan, however, mortality was suggested to decrease in 2020. This study investigated long-term mortality trends and cause-specific contributions, focusing on the period of the COVID-19 pandemic in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We analysed Japanese age-standardised mortality rates (ASMRs) from 1995 to 2021 using vital statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The cause-specific annual ASMR changes were calculated in comparison with the previous year over the abovementioned period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was a general downward trend in overall ASMR for both sexes until 2020 followed by a small increase in 2021. In men, the all-cause ASMR (per 100\u2009000 persons) decreased from 1352.3 to 1328.8 in 2020 (\u22121.74% from 2019), and increased to 1356.3 in 2021 in men (+2.07% from 2020). In women, the all-cause ASMR decreased from 746.0 to 722.1 in 2020 (\u22123.20% from 2019), and increased to 737.9 (+2.19% from 2020) in 2021. ASMRs from malignant neoplasms, pneumonia, accidents and suicide (men only) continued to decrease during the COVID-19 pandemic while the trend of cardiovascular mortality increased in 2021. Analysis of ASMR changes revealed that COVID-19, senility, cardiovascular disease and \u2018other causes not classified as major causes\u2019 contributed to the all-cause mortality increase in 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Japan, the decreasing trend in overall mortality continued in 2020 despite the COVID-19 pandemic. However, approximately 2% mortality increase was observed in 2021, which was attributable to COVID-19, senility, cardiovascular disease and \u2018other causes\u2019. The year 2021 was a turning point of mortality trends in Japan, although continued monitoring is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-071785","type":"journal-article","created":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T12:48:19Z","timestamp":1693486099000},"page":"e071785","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Impact of the COVID-19 pandemic on mortality trends in Japan: a reversal in 2021? A descriptive analysis of national mortality data, 1995\u20132021"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3153-8802","authenticated-orcid":false,"given":"Hirokazu","family":"Tanaka","sequence":"first","affiliation":[{"name":"Division of Population Data Science, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayo","family":"Togawa","sequence":"additional","affiliation":[{"name":"Division of Population Data Science, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kota","family":"Katanoda","sequence":"additional","affiliation":[{"name":"Division of Population Data Science, National Cancer Center Institute for Cancer Control, Chuo-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,8,31]]},"reference":[{"key":"2025121404322361000_13.8.e071785.1","unstructured":"The World Bank . Life expectancy at birth, total (years). Available: https:\/\/data.worldbank.org\/indicator\/SP.DYN.LE00.IN [Accessed 12 Dec 2022]."},{"key":"2025121404322361000_13.8.e071785.2","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2021-066768","article-title":"Effects of COVID-19 pandemic on life expectancy and premature mortality in 2020: time series analysis in 37 countries","volume":"375","author":"Islam","year":"2021","journal-title":"BMJ"},{"key":"2025121404322361000_13.8.e071785.3","unstructured":"Ministry of Health, Labour and Welfare . Vital Statistics. Available: https:\/\/www.mhlw.go.jp\/english\/database\/db-hw\/vs01.html [Accessed 12 Dec 2022]."},{"key":"2025121404322361000_13.8.e071785.4","unstructured":"Ministry of Health, Labour and Welfare . Visualizing the data: information on COVID-19 infections. Available: https:\/\/covid19.mhlw.go.jp\/en\/ [Accessed 12 Dec 2022]."},{"key":"2025121404322361000_13.8.e071785.5","doi-asserted-by":"crossref","first-page":"372","DOI":"10.2188\/jea.JE20220302","article-title":"Practical implications of the update to the 2015 Japan standard population: mortality archive from 1950 to 2020 in Japan","volume":"33","author":"Tanaka","year":"2023","journal-title":"J Epidemiol"},{"key":"2025121404322361000_13.8.e071785.6","unstructured":"World Health Organization . WHO Coronavirus (COVID-19) dashboard. Available: https:\/\/covid19.who.int [Accessed 12 Dec 2022]."},{"key":"2025121404322361000_13.8.e071785.7","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s00595-021-02406-2","article-title":"The impact of COVID-19 on surgical procedures in Japan: analysis of data from the National Clinical Database","volume":"52","author":"Ikeda","year":"2022","journal-title":"Surg Today"},{"key":"2025121404322361000_13.8.e071785.8","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.ccell.2021.01.002","article-title":"Changes in treatment behavior during the COVID-19 pandemic among patients at a cancer hospital","volume":"39","author":"Sato","year":"2021","journal-title":"Cancer Cell"},{"key":"2025121404322361000_13.8.e071785.9","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1007\/s12282-021-01272-7","article-title":"Negative impact of the COVID-19 state of emergency on breast cancer screening participation in Japan","volume":"28","author":"Toyoda","year":"2021","journal-title":"Breast Cancer"},{"key":"2025121404322361000_13.8.e071785.10","first-page":"1215","article-title":"Impact of the COVID-19 pandemic on the diagnosis of cancer in Japan: analysis of hospital-based cancer registries","volume":"52","author":"Okuyama","year":"2022","journal-title":"Jpn J Clin Oncol"},{"key":"2025121404322361000_13.8.e071785.11","doi-asserted-by":"crossref","DOI":"10.1016\/j.ssmph.2022.101196","article-title":"Excess deaths from non-COVID-19-related causes in Japan and 47 prefectures from January 2020 through may 2021 by place of death","volume":"19","author":"Nomura","year":"2022","journal-title":"SSM Popul Health"},{"key":"2025121404322361000_13.8.e071785.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00896-5"},{"key":"2025121404322361000_13.8.e071785.13","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.37378","article-title":"Assessment of suicide in Japan during the COVID-19 pandemic vs previous years","volume":"4","author":"Sakamoto","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2025121404322361000_13.8.e071785.14","doi-asserted-by":"crossref","first-page":"45","DOI":"10.2188\/jea.JE20220186","article-title":"The unusual increase in suicides among women in Japan during the COVID-19 pandemic: A time-series analysis until October 2021","volume":"33","author":"Kikuchi","year":"2023","journal-title":"J Epidemiol"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-071785","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T12:32:31Z","timestamp":1765715551000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-071785"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":14,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8,31]]},"published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1136\/bmjopen-2023-071785"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-071785","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8]]}}}