[Category] Healthcare & Diagnostics — Complete List of Medical Practices Verified by Academic Papers
About this category
"Even if you maintain a healthy lifestyle, the appropriate use of medical care remains a major determinant of healthy life expectancy."
Regular checkups, cancer screenings, vaccinations, blood pressure management, and blood sugar management—these have been proven by multiple large-scale studies to be habits with an extremely high cost-effectiveness ratio.
This category outlines 13 medical practices for which there is established evidence and clear recommendations. It has been compiled with a focus on making the most of Japan’s health insurance system and public health screening programs.
🩺 Vital Signs Monitoring (3 parameters)
1. Blood pressure management (target <120/80 mmHg) — Level 1: Strongly recommended
One-line summary: Blood pressure-lowering therapy reduces all-cause mortality, stroke, myocardial infarction, and dementia.
Effect size:
– SPRINT Trial: Systolic blood pressure <120 vs. <140 resulted in a 25% reduction in cardiovascular events (27% reduction in all-cause mortality)
– For every 10 mmHg reduction in blood pressure: 27% reduction in stroke risk, 17% reduction in cardiovascular disease risk
– Dementia: Evidence Suggests Aggressive Blood Pressure Control May Reduce the Risk of Onset
Recommended:
– Measure your blood pressure at home at least three times a week (morning and evening)
– Systolic <130 mmHg (general population), <120 mmHg (high cardiovascular risk)
– Reduce salt intake to less than 6 grams per day, exercise, lose weight, and limit alcohol consumption
– If symptoms persist beyond the standard threshold, consult a healthcare provider
Supporting papers:
– SPRINT Research Group (2015). A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med, 373:2103-2116.
– Ettehad D, et al. (2016). Blood pressure lowering for prevention of cardiovascular disease and death. Lancet, 387:957-967.
👉 （Individual article coming soon）
2. Management of fasting blood glucose and HbA1c — Level 1: Strongly recommended
Effect size:
– Diabetes: Achieving an HbA1c target of <7.0%: Reduced risk of cardiovascular events
– Lifestyle interventions reduce the risk of developing diabetes by 58% in individuals with prediabetes (HbA1c 5.7–6.4%) (DPP study)
– Diabetes: All-cause mortality HR 1.8–2.0
Recommended:
– Annual HbA1c testing (for those aged 40 and older; available during health checkups)
– Target: HbA1c <5.6% (threshold for prediabetes)
– If over 5.7%, focus on improving lifestyle habits; if over 6.5%, consult a healthcare provider
– Postprandial hyperglycemia is also important: Consider using continuous glucose monitoring (CGM)
👉 （Individual article coming soon）
3. LDL Cholesterol and Lipid Management — Level 1: Strongly Recommended
Effect size:
– For every 40 mg/dL reduction in LDL: 23% reduction in major cardiovascular events (CTT Collaboration)
– Statin therapy: Approximately 25% reduction in myocardial infarction, 15% reduction in stroke
– In high-risk groups, the combination of statins and ezetimibe is effective
Recommended Targets (Japanese Society of Atherosclerosis, 2022):
– Primary prevention/low risk: LDL <160 mg/dL
– Moderate risk: <140 mg/dL
– High risk (diabetes, chronic kidney disease, etc.): <120 mg/dL
– Secondary prevention (history of myocardial infarction, etc.): <70 mg/dL
Lifestyle habits:
– Replacement of saturated fats with unsaturated fats
– Fish twice a week, olive oil
– At least 25 grams of dietary fiber per day
– Regular exercise
👉 （Individual article coming soon）
🔍 Cancer Screening (4 Tests)
4. Colorectal cancer screening (fecal occult blood test + colonoscopy for those aged 50 and older) — Level 1: Strongly recommended
Effect size:
– Annual fecal occult blood test: 15–33% reduction in colorectal cancer mortality (Towler et al., Cochrane 2007)
– Colonoscopy: Preventing the onset of the disease through polyp removal (Zauber et al., NEJM 2012; 40% reduction in mortality)
Recommended:
– Annual fecal occult blood test starting at age 40 (free or up to 500 yen through municipal health screenings)
– One colonoscopy at age 50 (then every 5 to 10 years)
– If the result is positive, a thorough examination via endoscopy is required
👉 （Individual article coming soon）
5. Breast cancer screening (mammography for women aged 40 and older) — Level 1: Strongly recommended
Effect size:
– Regular screenings for women aged 50–69: 20% reduction in breast cancer mortality (Marmot et al., 2013)
– Peak incidence of breast cancer among Japanese women: late 40s
– For dense breasts, the use of ultrasound is recommended
Recommended:
– Mammograms every two years for women aged 40 and older
– If there is a family history or risk factors, start treatment at an earlier age
– Combined with a monthly self-check
👉 （Individual article coming soon）
6. Cervical Cancer Screening (HPV Test and Pap Smear) — Level 1: Strongly Recommended
Effect size:
– HPV testing + Pap smear: High rate of early detection of precancerous cervical lesions
– One of the few cancers that can be almost entirely prevented through HPV vaccination and regular screenings
Recommended:
– Women aged 20 and older: a Pap test every 2 to 3 years
– The HPV vaccine is strongly recommended for those within the routine vaccination age range
– Women born between April 2, 1994, and April 1, 2006, are eligible for catch-up vaccinations (until the end of March 2025) → Check for the latest information, as the deadline may be extended
👉 （Individual article coming soon）
7. Stomach cancer screening (endoscopy or barium enema—ages 50 and older) — Level 2: Strongly recommended
Effect size:
– Endoscopic screening: 30–46% reduction in gastric cancer mortality (Hamashima et al., 2013; South Korean and Japanese study)
– Preventing stomach cancer through Helicobacter pylori eradication
Recommended:
– Endoscopy every two years starting at age 50
– Get tested for H. pylori in your 40s; if the result is positive, undergo eradication therapy
– Continue regular checkups even after H. pylori eradication (the risk does not disappear completely)
👉 （Individual article coming soon）
💉 Vaccines (3 items)
8. Flu vaccine (annual) — Level 1: Strongly recommended
Effect size:
– Healthy adults: 50–60% reduction in the risk of developing the disease
– Older adults: 25–40% reduction in hospitalizations, 40% reduction in deaths
– There is also evidence of a reduction in cardiovascular events
Recommended:
– Get vaccinated every year in October or November
– People aged 65 and older are eligible for routine vaccinations (partially subsidized)
– High-dose vaccines are also an option for older adults
👉 （Individual article coming soon）
9. Pneumococcal vaccine (ages 65 and older) — Level 1: Strongly recommended
Effect size:
– A 75% reduction in invasive pneumococcal disease
– Hospitalizations for pneumonia down by 20–30%
Recommended:
– At age 65: 1 dose of PPSV23 (Neumovax) (routine vaccination)
– In combination with PCV13 / PCV15 / PCV20 (self-pay or conditional subsidy)
– If you have high-risk conditions such as diabetes, COPD, or chronic kidney disease, seek medical attention early
👉 （Individual article coming soon）
10. Shingles vaccine (ages 50 and older) — Level 1: Strongly recommended
Effect size:
– Shingrix: Over 90% effective in preventing the onset of shingles; highly effective in preventing postherpetic neuralgia
– Conventional varicella vaccine (attenuated live): 50–60% efficacy
Recommended:
– Recommended for people aged 50 and older, especially those in their 60s
– Singrix: 2 doses (administered 2 months apart)
– To be gradually incorporated into routine vaccination programs starting in 2025–2026 (depending on the municipality)
👉 （Individual article coming soon）
📋 Routine checkup (2 items)
11. Full participation in workplace and specific health checkups — Level 1: Strongly recommended
Effect size:
– The rate of early disease detection is higher among those who have been screened than among those who have not
– Reducing the duration of untreated lifestyle-related diseases
– Occupational health examinations are a legal requirement (for employees)
Recommended:
– Annual health checkups
– Basic tests: Height, weight, blood pressure, urine, blood (liver, kidney, lipids, blood sugar)
– Individuals aged 40 and older are eligible for the Specific Health Checkup (Metabolic Syndrome Screening)
Important:
– Track annual numerical trends rather than focusing on the "outcome"
– Don’t ignore a “need for further testing” notice
– Additional optional tests based on family history and symptoms
👉 （Individual article coming soon）
12. Comprehensive Health Checkup, Brain Checkup, and Heart Checkup (Optional) — Level 2 · Recommended
Effect size:
– Benefits for the early detection of asymptomatic cases in young to middle-aged adults
– There is also a risk of overdiagnosis (the detection of minor abnormalities that are clinically insignificant)
– This is particularly valuable for individuals aged 50 or older who have a family history of heart disease or stroke
Recommended:
– A basic health checkup plus a brain MRI and coronary CT scan every five years is an appropriate frequency
– A smart health screening program with a focused set of tests
– "Getting tested for everything under the sun" isn't necessarily good for your health
👉 （Individual article coming soon）
🧬 New Frontiers in Preventive Medicine (1 item)
13. Genetic Testing and Precision Health (Smart Use) — Level 3 (Conditional)
Effect size:
– Clinically well-defined high-risk genes such as BRCA1/2 have clinical utility
– Polygenic risk scores (PRS) are just beginning to be used in clinical practice
– The medical value of consumer genetic testing (such as MyHeritage and 23andMe) is limited
Recommended:
– Medical testing with genetic counseling if there is a family history of the condition
– "Exercise proteomics testing" and similar approaches are still in the research phase
– Don’t let your genes dictate your life; focus on factors you can control
👉 （Individual article coming soon）
📊 Recommended Health Practices by Age Group
in their 30s
- Annual health checkup
- Women: Cervical cancer screening; for those in their 20s, regular gynecological checkups
- HPV Vaccine (Eligible for Catch-Up Vaccination)
- Risk Assessment Based on Family History
in their 40s
- Start of the Specific Health Checkup
- Women: Start mammography
- Helicobacter pylori test
- Annual fecal occult blood test
- Early Detection and Lifestyle Management of Hypertension and Dyslipidemia
in their 50s
- First Colonoscopy
- Gastroscopy every two years
- Shingles vaccine
- Considering a Comprehensive Health Checkup
- Bone density testing (especially for women)
60 and older
- Pneumococcal vaccine (age 65)
- High-dose influenza vaccine
- Cognitive Function Screening
- Annual hearing test
- Frailty Assessment
💡 Balancing "Excess" and "Shortage" in Healthcare
The Risks of Overmedicalization
- PSA Testing: Prostate Cancer Screening Is a Matter of Debate. We Must Weigh the Harms of Overdagnosis and Overtreatment
- Excessive imaging tests: Radiation exposure, false positives → Additional tests
- Excessive Supplement Intake: See the previous category
- Unnecessary Antibiotics: The Problem of Antibiotic-Resistant Bacteria
Losses due to inadequate medical care
- Neglecting High Blood Pressure and Diabetes
- Have not undergone cancer screening
- Unvaccinated
- Failure to visit the dentist
"Maximum impact with minimal intervention"—this is the philosophy of preventive medicine in 2026.
🎯 How to Choose a Primary Care Physician
- understands the physical constitution and medical history of every member of the family
- Listens to patients (doesn't just prescribe medication in five minutes)
- They will refer you to a specialist as appropriate
- Conveniently located nearby
- A proactive approach to preventive healthcare
Having a primary care physician contributes to healthy life expectancy through the longitudinal management of medical data.
🔗 Related Pages
⚠️ Disclaimer
This category provides general information on preventive healthcare. For specific medical decisions, please consult your primary care physician or a specialist. If you experience emergency symptoms (such as chest pain, difficulty breathing, or loss of consciousness), seek emergency medical care immediately.
evidage Editorial Department / Hydro Wing Lab Co., Ltd. / April 23, 2026
