Cancer Awareness and Understanding of Students in Japan: What Do Students Having Close Relatives with Cancer Think About the Disease?


Students have become more familiar with cancer because of media, such as television or the Internet, reporting on celebrity cancer cases. Moreover, with Japan’s increasing age and cancer rates, the number of students whose parents/relatives develop cancer is likely to increase. This study examined cancer awareness and understanding among students aged 10 to 16 or more. A cross-sectional nationwide survey was conducted using a self-administered questionnaire. Cancer awareness and cancer understanding were assessed using a self-administered questionnaire. We collected a total of 9139 questionnaires and excluded those with missing data. Thus, we analyzed the responses of 8701 students: 2135, 2902, and 3664 from elementary, junior, and high school, respectively. Data were analyzed using a multivariable model adjusted for gender and grade. Approximately 30% of respondents had parents/relatives with cancer. In addition, there was a significant association between having parents/relatives with cancer and cancer awareness; however, students having parents/relatives with cancer had more negative awareness (i.e., “I think cancer is scary,” “I think I will get cancer in the future,” and “I think cancer is preventable”). Furthermore, there was a significant association between cancer understanding and awareness. These findings suggest that cancer education could have a desirable effect on students whose parents/relatives have cancer. Further, cancer education offers benefits to students who are naive about cancer and ill prepared to cope when a family member discloses a cancer diagnosis.

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  1. 1.

    Center for Cancer Control and Information Services, National Cancer Center, Japan. Cancer Registry and Statistics (2018) Newest cancer statistics Accessed 1 March 2018

  2. 2.

    Center for Cancer Control and Information Services, National Cancer Center, Japan. Cancer Registry and Statistics (2017) Cancer screening rates. Accessed 1 March 2018

  3. 3.

    Cabinet Office (2018) Annual report on the aging society

  4. 4.

    Center for Cancer Control and Information Services, National Cancer Center, Japan (2017) Annual transition. Accessed 1 March 2018

  5. 5.

    Hori M, Matsuda T, Shibata A, Katanoda K, Sobue T, Nishimoto H, Japan Cancer Surveillance Research Group (2015) Cancer incidence and incidence rates in Japan in 2009: a study of 32 population-based cancer registries for the Monitoring of Cancer Incidence in Japan (MCIJ) project. Jpn J Clin Oncol 45:884―991

    Google Scholar 

  6. 6.

    Ministry of Health, Labor and Welfare (2018) Demographic statistics.

  7. 7.

    Johnson LS (1997) Developmental strategies for counseling the child whose parent or sibling has cancer. J Couns Dev 75:417–427

    Article  Google Scholar 

  8. 8.

    Weaver KE, Rowland JH, Alfano CM, McNeel TS (2010) Parental cancer and the family: a population-based estimate of the number of US cancer survivors residing with their minor children. Cancer 116:4395–4401

    Article  Google Scholar 

  9. 9.

    Syse A, Aas GB, Loge JH (2012) Children and young adults with parents with cancer: a population-based study. Clin Epidemiol 4:41―52

    PubMed  PubMed Central  Google Scholar 

  10. 10.

    Inoue I, Higashi T, Iwamoto M, Heiney SP, Tamaki T, Osawa K, Inoue M, Shiraishi K, Kojima R, Matoba M (2015) A national profile of the impact of parental cancer on their children in Japan. Cancer Epidemiol 39(6):838―841

    Article  Google Scholar 

  11. 11.

    Cabinet Office (2017) A 2017 declining birthrate white paper

  12. 12.

    Statistics Bureau, Ministry of Internal Affairs and Communications (2017) Children’s number was 15.53 million, decreased for 37 consecutive years. Available at: Accessed 1 March 2018

  13. 13.

    Public Interest Incorporated Foundation of the Japan Society of School Health (2014) Examination committee about the education of cancer report. Accessed 1 March 2018

  14. 14.

    Examination meeting hosted to discuss what “cancer education” (2016) Report about the way of the cancer education in the school. Accessed 1 March 2018

  15. 15.

    Sugisaki K, Ueda S, Monobe H, Yako-Suketomo H, Eto T, Watanabe M, Mori R (2014) Cancer understanding among Japanese students based on a nationwide survey. Environ Health Prev Med 19:395–404

    Article  Google Scholar 

  16. 16.

    Yako-Suketomo H, Katanoda K, Kawamura Y, Katayama K, Yuasa M, Horinouchi H, Saito K (2018) Children’s knowledge of cancer prevention and perceptions of cancer patients: comparison before and after cancer education with the presence of visiting lecturer-guided class. J Cancer Educ.

  17. 17.

    Ministry of Education, Culture, Sports, Science, and Technology Japan (2017) Junior high school teacher guide for course of study. Health and physical education. Accessed 1 March 2018

  18. 18.

    Ministry of Education, Culture, Sports, Science, and Technology Japan (2017) Elementary school teaching guide for course of study: physical education. Accessed 1 March 2018

  19. 19.

    Yako-Suketomo H (2016) Health instruction and cancer education in the elementary school. Child Health 92:2–3 (in Japanese)

    Google Scholar 

  20. 20.

    Ueda S (2016) Cancer education-from the point of view of education. Public Health 80:91–96 (in Japanese)

    Google Scholar 

  21. 21.

    Eto T (2017) Cancer education in the school health education. Health Care 59:724–730 (in Japanese)

    Google Scholar 

  22. 22.

    Ueda S (2017) How to lead and thinking of cancer education in the school. Health Care 59:731–735 (in Japanese)

    Google Scholar 

  23. 23.

    Ueda S, Sugisaki K, Monobe H, Eto T, Watanabe M, Yako-Suketomo H, Mori R (2014) Actual status of cancer awareness among Japanese school students. Jpn J Sch Health 56:185–198 (In Japanese)

    Google Scholar 

  24. 24.

    Monobe H, Ueda S, Sugisaki K, Eto T, Watanabe M, Yako-Suketomo H, Mori R (2014) A study of information sources and recognition of causes of cancer in Japanese school students. Jpn J Sch Health 56:262–270 (In Japanese)

    Google Scholar 

  25. 25.

    Zenkoku Gakkosouran (2012) Tokyo: Harashobo. (In Japanese)

  26. 26.

    Oakley A, Bendelow G, Barnes J, Buchanan M, Husain OA (1995) Health and cancer prevention: knowledge and beliefs of children and young people. BMJ 310:1029–1033

    CAS  Article  Google Scholar 

  27. 27.

    Knighting K, Rowa-Dewar N, Malcolm C, Kearney N, Gibson F (2010) Children’s understanding of cancer and views on health-related behavior: a ‘draw and write’ study. Child Child Care Health Dev 37:289―299

    Google Scholar 

  28. 28.

    Hosmer DW, Lemeshow S, Sturdivant RX (2013) Applied logistic regression. Wiley, Hoboken

    Google Scholar 

  29. 29.

    Huizinga GA, Visser A, Zelders-Steyn YE, Teule JA, Reijneveld SA, Roodbol PF (2011) Psychological impact of having a parent with cancer. Eur J Cancer 47:S239–S246

    Article  Google Scholar 

  30. 30.

    Huizinga GA, Visser A, Van der Graaf WT, Hoekstra HJ, Stewart RE, Hoekstra-Weebers JE (2011) Family-oriented multilevel study on the psychological functioning of adolescent children having a mother with cancer. Psycho-oncology 20:730–737

    Article  Google Scholar 

  31. 31.

    Gazendam-Donofrio SM, Hoekstra HJ, van der Graaf WT, van de Wiel HB, Visser A, Huizinga GA, Hoekstra-Weebers JE (2007) Family functioning and adolescents’ emotional and behavioral problems: when a parent has cancer. Ann Oncol 18:1951–1956

    CAS  Article  Google Scholar 

  32. 32.

    Sugisaki K, Ueda S, Ueji M, Monobe H, Yako-Suketomo H, Eto T, Watanabe M, Mori R (2018) A cross-sectional investigation of cancer-screening intentions, sources of information, and understanding of cancer in Japanese adolescents. J Cancer Educ 33:102–108

    Article  Google Scholar 

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Gratitude is expressed to the students who participated in this survey and the concerned officials in the cooperating school.


This work was financially supported by Clinical Cancer Research for Health Labour Sciences Research Grants of the Ministry of Health, Labour and Welfare of Japan and JSPS KAKENHI Grant Number JP18H00998.

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Corresponding author

Correspondence to Koshu Sugisaki.

Ethics declarations

We received approval from the ethics committee of Niigata University of Health and Welfare before conducting the study. Moreover, the survey was carried out once participants were informed that their anonymity and freedom to participate would be guaranteed, as outlined in the survey manual. The front page of the survey form stated the survey objectives and procedures; moreover, participant anonymity, the fact that participation in the survey would not affect school grades, and the freedom to participate in and withdraw from the study were also clearly explained in the survey.

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The authors declare that they have no conflicts of interest.

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Sugisaki, K., Ueda, S., Yako-Suketomo, H. et al. Cancer Awareness and Understanding of Students in Japan: What Do Students Having Close Relatives with Cancer Think About the Disease?. J Canc Educ 36, 92–99 (2021).

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  • Parental cancer
  • Cancer education
  • Educational considerations