{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:36:59Z","timestamp":1791405419429,"version":"4.3.3"},"reference-count":40,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ministry of Health, Labour, and Welfare, Japan","award":["23EA1034"],"award-info":[{"award-number":["23EA1034"]}]},{"name":"Japan Society for the Promotion of Science (JSPS) KAKENHI","award":["23K16341"],"award-info":[{"award-number":["23K16341"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2026,2,25]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Reports on socioeconomic inequalities in cancer mortality are limited in East Asia. We investigated educational inequalities in cancer mortality in Japan, serving as an advanced example of a nationwide census-based surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We developed a Japanese census-linked mortality dataset, using our unique linkage method. The dataset encompassed approximately 0.48\u2009million cancer deaths linked to individual-level census data of 80\u2009million Japanese aged 25\u201384 years in October 2020. We calculated age-standardised all-cancer and 23 site-specific cancer mortality rates (ASMRs) by educational level. Educational inequalities were quantified using the Relative Index of Inequality (RII) and Slope Index of Inequality (SII) by educational level (high, middle and low). Site-specific cancer contribution to absolute educational inequalities in all cancers was evaluated using the proportions of SII (%: SII\n                      <jats:sub>Cancer-site<\/jats:sub>\n                      \/SII\n                      <jats:sub>All-cancer<\/jats:sub>\n                      \u00d7100).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All cancers\u2019 RIIs were 1.58 (95% CI 1.56 to 1.60)\u2009and 1.43 (1.40 to 1.46) in men and women, respectively. Among men, the rectum, stomach, liver and lung were the leading sites based on site-specific cancer RIIs, while the larynx, cervix uteri, liver and lung were the leading sites among women. In absolute terms, lung cancer contributed the most to educational inequalities, followed by stomach, colorectal and liver cancers. No educational inequality was found for pancreatic cancer. Breast cancer showed higher ASMRs among women with low education levels than among those with high education levels, which differed from the previous inequality pattern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Equity-focused strategies to enhance primary and secondary prevention are essential and should be supported by comprehensive nationwide monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jech-2025-225721","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T18:20:31Z","timestamp":1772821231000},"page":"600-607","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Educational inequalities in site-specific cancer mortality: a Japanese census-linked study"],"prefix":"10.1136","volume":"80","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, 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, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Nakaya","sequence":"additional","affiliation":[{"name":"Department of Frontier Science for Advanced Environment, Graduate School of Environmental Studies, Tohoku University, Sendai, Japan"},{"name":"Department of Earth Science, Graduate School of Science, Tohoku University, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayo","family":"Togawa","sequence":"additional","affiliation":[{"name":"Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC\/WHO), Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"The University of Tokyo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"2026070902102002000_80.8.600.1","unstructured":"The U.S. Centers for Disease Control and Prevention (CDC) . 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