[Tuberculosis control and technology assessment in Japan with special reference to cancer control]

Tuberculosis morbidity and mortality statistics show that tuberculosis control efforts in Japan have recently borne little fruit. Almost a similar situation has occurred in cancer control efforts in Japan. To overcome these difficulties, we should introduce the principles of evidence-based healthcare into control activities and each activity of tuberculosis control and cancer control should be evaluated strictly by technology assessment. The most important issue to be discussed is that screening programs for tuberculosis and various cancers have been eagerly conducted in Japan as a public health policy since 1951 and 1961 and there has been no change of "Early diagnosis/early treatment is best" policy although many changes have occurred around the diseases and the society since then. From the viewpoint of a cancer epidemiologist, the significance of screening tests for tuberculosis, the completeness of tuberculosis registries, the significance of tuberculosis registries as a monitoring system for tuberculosis treatment and the role of health centers in the new programs of tuberculosis control are discussed.