Guides · がん検診 · gan kenshin
Cancer Screening in Japan — The ¥500 Tests Your City Keeps Offering You
Every year, your city quietly offers to screen you for the major cancers for a few hundred yen — sometimes free. The offer arrives as a postcard many foreign residents cannot read, gets filed with the recycling, and one of the best-value services in Japanese healthcare goes unused. This guide is the missing translation.
The five national programs
Japan runs organized, subsidized screening for five cancers, with eligibility set nationally and delivery run by municipalities. As of 2026:
| Cancer | Who | How often | Test |
|---|---|---|---|
| Colorectal (大腸がん) | 40+ | Every year | Stool test (FIT) — done at home |
| Lung (肺がん) | 40+ | Every year | Chest X-ray (± sputum test) |
| Stomach (胃がん) | 50+ | Every 2 years | Endoscopy or barium X-ray¹ |
| Breast (乳がん) | Women 40+ | Every 2 years | Mammography |
| Cervical (子宮頸がん) | Women 20+ | Every 2 years | Cytology (smear)² |
¹ Barium X-ray remains available from 40 annually in some municipalities. If you are offered the choice, endoscopy finds more and most gastroenterologists would choose it for themselves. ² An HPV-test-based option every 5 years is being introduced for ages 30–60 in municipalities that have adopted it.
Municipal prices are the striking part: typically ¥0–2,000 per test, versus ¥10,000–40,000 for the identical tests done privately. Many cities make everything free in milestone years (40, 45, 50…) or for residents on low income.
How it actually works
Around the start of the fiscal year (April–June), your city mails eligible residents a notification or voucher set (がん検診のお知らせ/受診券). Depending on the city, you then either book directly at a participating local clinic from an enclosed list, book a slot at a municipal health-center screening day (集団検診 — the efficient assembly-line version, sometimes in a mobile van), or, for the stool test, simply collect a kit at a clinic or the health center, do it at home, and drop it back.
Results come by post in two to four weeks. Two possible outcomes: 異常なし (no abnormality — done until next round) or 要精密検査 (detailed examination needed). If you have read our health checkup guide, you know the rule: this second envelope is the one that must never be ignored — and also usually ends in reassurance. The follow-up examination moves into ordinary insured care (30% co-pay, cap applies).
If you missed or lost the mailing, nothing is lost: call the city health center (保健センター) or check the city website for がん検診 — vouchers can be reissued, and mid-year enrolment is normal.
"Doesn't my company checkup cover this?"
Mostly no, and this misconception is the most common screening gap in Japan. The annual workplace checkup is a general health exam — blood pressure, bloods, urine, chest X-ray. Of the five cancer screenings, it incidentally includes only the lung X-ray. Colorectal, stomach, breast and cervical screening are not part of the standard employee checkup unless your employer buys an expanded package or you pay for an optional add-on (オプション) yourself.
So the realistic setup for an employed 45-year-old woman, for example, is: workplace checkup each year plus the city's FIT kit each year plus mammography and cervical screening in alternating years via city vouchers. Total annual cost: a few thousand yen and about two hours.
The fuller private alternative is the ningen dock (人間ドック) — the famous half-day full-course examination, ¥40,000–150,000, sometimes employer-subsidized. It is comprehensive and comfortable, and for most people the municipal programs cover the highest-value pieces of it at one-fortieth the price.
Honest notes from the evidence side
Screening is one of the areas where Japanese practice and international guidelines are converging but not identical, and an informed adult can hold two thoughts at once. The five national programs above are the evidence-backed core — colorectal FIT and cervical screening in particular are among the best-proven cancer screens in existence, and both are underused in Japan's foreign population.
At the same time: PSA testing for prostate cancer is not in the national program (offered by many municipalities anyway — discuss the trade-offs before testing rather than after); tumor-marker blood panels sold as checkup options have poor evidence as screening tools in asymptomatic people; and screening intervals exist for a reason — annual mammography instead of biennial mostly buys more false alarms, not more life. When in doubt, the national five, on schedule, is the rational default.
Screening is for people without symptoms. A new lump, visible blood, unexplained weight loss, a persistent change — those are not screening questions; book an ordinary clinic visit this week instead of waiting for a postcard.
General information, reviewed against the national screening guidelines current in 2026. Municipal details vary. Individual risk (family history, prior findings) can justify different plans — that conversation belongs with your doctor.