Workplace Checkups Once a Year, Specific Health Checkups From Age 40: Cancer Screening Through Your City or Ward

Living in Japan, you may receive several notices that all say “health checkup” (kenkou shindan). One from your employer, one for a “specific health checkup” (tokutei kenshin) receipt from your health insurer, one about cancer screening from your city, town, or ward. The names sound alike, but the laws behind them, who carries them out, and who is covered all differ.

Below is based on the Industrial Safety and Health Act, the Act on Assurance of Medical Care for Elderly People, and the Health Promotion Act (e-Gov Japanese Law Search), and on publications from the Ministry of Health, Labour and Welfare (MHLW), the Japan Health Insurance Association (Kyokai Kenpo), and local governments, as of September 2026. This article does not judge which checkup you should receive, when, or how to read the results. Check whether you are covered with the contact points listed at the end.

Three Checkups, Three Different Organizers

	Workplace health checkup	Specific health checkup	Cancer screening
Legal basis	Industrial Safety and Health Act Article 66; Ordinance on Industrial Safety and Health Articles 43 and 44	Act on Assurance of Medical Care for Elderly People, Article 20	Health Promotion Act Article 19-2; MHLW guidelines
Who carries it out	Your employer (the business operator)	The health insurer you belong to. For National Health Insurance, the city, town, or ward	The city, town, or ward you live in
Who is covered	“Workers who are regularly employed”	Insured people aged 40 to 74	Residents of the city, town, or ward. The age depends on the type
How binding it is	The employer is obligated to carry it out. Workers are also obligated to receive it	Insurers are required to carry it out	An effort obligation for the city, town, or ward

Workplace Health Checkups: At Hiring, and Once Every Year

Article 66 of the Industrial Safety and Health Act obligates employers (companies and other business operators) to have a physician conduct health checkups for their workers. The Ordinance on Industrial Safety and Health sets out a checkup at the time of hiring (Article 43) and a periodic checkup at least once every year (Article 44). Workers engaged in specified jobs, such as late-night work, must be checked at least once every six months (Article 45).

Paragraph 5 of the same Article 66 also obligates workers to undergo the checkup their employer arranges. However, a worker may instead have an equivalent checkup done by a physician other than the one the company designates and submit the results to the company. If you submit the results of a checkup received within the three months before hiring, those items can be omitted (proviso to Ordinance Article 43).

When Part-Time and Casual Workers Are Covered

Coverage is for “workers who are regularly employed.” An MHLW leaflet (April 2026) explains this as someone whose contract period is one year or more (including an expected one year or more) and whose weekly working hours are at least three-quarters of those of a regular worker doing the same kind of job. The 生活・就労ガイドブック (Guidebook on Living and Working, Japanese-language 8th edition), supervised by the Immigration Services Agency of Japan (ISA), likewise states that dispatched workers, contract workers, and part-time or casual workers who meet these two conditions are covered, in addition to regular employees. Neither the statutory text nor this explanation sets any condition based on nationality or status of residence.

What Is Checked, and Who Pays

The items for the periodic health checkup are set out in Article 44 of the Ordinance: 11 items in all — a review of medical and occupational history; examination for subjective and objective symptoms; height, weight, waist circumference, vision, and hearing; chest X-ray and sputum examination; blood pressure; anemia testing; liver function testing; blood lipid testing; blood glucose testing; urinalysis; and electrocardiography. Some items may be omitted if a physician judges them unnecessary, based on criteria the Minister of Health, Labour and Welfare sets.

On cost, the Ministry of Health, Labour and Welfare states that “since the law obligates the employer to carry out the health checkup, it is naturally the employer who should bear the cost.” Employers must notify the individual of the results (Article 66-6 of the Act), and an employer who regularly employs 50 or more people reports the results of the periodic checkup to the labour standards inspection office (per the same ministry’s leaflet).

Some Items Change From April 2027

Under a revision to the Ordinance on Industrial Safety and Health and related rules (Ministry of Health, Labour and Welfare Ordinance No. 89 of 2026), promulgated on April 28, 2026, the following will change from April 1, 2027. According to the ministry’s notice (April 28, 2026), a serum creatinine test, which checks kidney function, will be added to the checkup at hiring and the periodic checkup, the sputum examination that had been required at the periodic checkup and elsewhere will be removed, and the names of liver-function enzymes will be aligned with international recommendations. The serum creatinine test may be omitted for people under 40 if a physician judges it unnecessary.

Specific Health Checkups: Ages 40 to 74, Run by the Insurer

Article 20 of the Act on Assurance of Medical Care for Elderly People provides that insurers (the bodies that run health insurance) carry out “specific health checkups” for insured people aged 40 and over. This is a checkup focused on lifestyle-related diseases such as diabetes, and the MHLW states the coverage as ages 40 to 74. For people 75 and over, who join the Late-Stage Elderly Healthcare System, the wide-area union is to make efforts to carry out health checkups and the like (Article 125 of the same Act).

Who sends you the notice depends on which health insurance you belong to.

• You yourself, insured through your workplace’s health insurance: if you have received your workplace health checkup, that checkup is deemed to have also served as the specific health checkup (Article 21 of the same Act). It is not a system where you receive both separately.
• A family member covered as a dependent under workplace health insurance: notice comes from that health insurer.
• People on National Health Insurance: the city, town, or ward carries out the specific health checkup for National Health Insurance (Article 19 of the same Act).

Insurers carry out specific health checkups under six-year plans, and the current one is the fourth period (fiscal 2024 to fiscal 2029). Some insurers add their own checkups on top. The Japan Health Insurance Association (Kyokai Kenpo), for example, offers its “Lifestyle Disease Prevention Checkup” general checkup for the insured themselves, covering ages 35 to 74, and states that from fiscal 2026 it has also added a checkup available to people aged 20, 25, and 30 (the out-of-pocket cost is set for each type of checkup).

Cancer Screening: Run by the City, Town, or Ward You Live In

Article 19-2 of the Health Promotion Act and Article 4-2 of its enforcement regulations list cancer screening as one of the undertakings that a city, town, or ward is to make efforts to carry out. What is screened, from what age, and at what interval are set out in the Ministry of Health, Labour and Welfare’s “Guidelines for Priority Health Education for Cancer Prevention and for Implementing Cancer Screening.” The guidelines list the following five types.

Type	Target age (per the guidelines)	Interval	Screening items
Stomach cancer	50 and over (X-ray examination may still be offered from age 40, for the time being)	Once every 2 years (X-ray may still be offered annually, for the time being)	Interview, plus either a stomach X-ray examination or an upper gastrointestinal endoscopy
Cervical cancer	Women aged 20 and over (the HPV-test-only method: 30 and over)	Cytology once every 2 years; HPV-test-only method once every 5 years	Interview, visual inspection, cytology, pelvic examination, etc., or an HPV test
Lung cancer	40 and over	Once a year	Questionnaire and chest X-ray examination
Breast cancer	Women aged 40 and over	Once every 2 years	Interview and breast X-ray examination (mammography)
Colorectal cancer	40 and over	Once a year	Interview and fecal occult blood test

The guidelines describe those covered as people “who have a residence within the area of the municipality concerned.” There is no condition based on nationality.

What Changed in the Guidelines From 2024 to 2026

• From April 2024: the “HPV-test-only method” (age 30 and over, once every 5 years) was added to cervical cancer screening. According to MHLW materials, this is for municipalities that meet requirements such as being able to track screening history in a database over the long term; other municipalities continue with cytology every 2 years.
• From July 2025: it was added that municipalities are to make efforts to grasp residents’ status of receiving cancer screening at their workplace or elsewhere (per a report from Aomori Prefecture).
• From April 2026: sputum cytology was removed from the items for lung cancer screening (per an MHLW notice of December 24, 2025). In its place, guidance to see a medical institution promptly has been added for people with a persistent cough.

The number of types — five — and the target age for each have not changed over this period.

What Differs by City, Town, or Ward

The guidelines are a national benchmark; the actual coverage, cost, and how to apply are decided by each city, town, or ward. Here are two fiscal-2026 examples.

• Yokohama City: in addition to the guidelines’ five types, it also offers prostate cancer screening for men aged 50 and over. The out-of-pocket cost is 2,500 yen for stomach cancer screening and 680 yen for lung and breast cancer screening, among others, and it is free for people 65 and over. Colorectal cancer screening is free in fiscal 2026.
• Osaka City: coverage is for people registered as residents of Osaka City. People who can receive the same screening through their insurer or workplace that fiscal year are excluded. For lung cancer screening, people aged 50 and over with a smoking index of 600 or more will still be given sputum examination in fiscal 2026. A breast ultrasound examination is also available for women in their 30s.

As this shows, some cities, towns, and wards continue or add items that go beyond the national guidelines. Check your own municipality’s website or public bulletins for what is covered and what it costs.

What Is Available in Ukrainian

The Ukrainian-language edition (7th edition) of the 生活・就労ガイドブック (Guidebook on Living and Working), supervised by the Immigration Services Agency of Japan, explains who is covered by workplace health checkups (someone on a contract with no fixed term or of one year or more, whose weekly working hours are at least three-quarters of a regular worker’s) in Chapter 12, section 3, “Office Work and Manual Labor,” subsection “(2) Medical Checkups and So On.” The Japanese-language edition has since been revised to the 8th edition and includes content, such as an explanation of stress checks, that differs from the Ukrainian edition. Specific health checkups and cancer screening are not covered in this guidebook.

Where to Ask

• Workplace health checkups: first, the person in charge at your workplace. For questions about the rules themselves, the Prefectural Labour Bureau or the labour standards inspection office takes consultations.
• Specific health checkups: the insurer named on your insurance card or certificate of eligibility. For National Health Insurance, the counter at your city, town, or ward.
• Cancer screening: the health-promotion department (such as a public health center) of the city, town, or ward you live in.

How to enroll in health insurance and pension is covered in our article on health insurance and pension, what to prepare before visiting a hospital in our article on visiting a hospital in Japan, and the system for when medical costs run high in our article on the High-Cost Medical Expense Benefit.