• childhood cancer;
  • health certificate;
  • long-term survivors;
  • job application;
  • social discrimination


Background:  The aim of this study was to investigate the policies to identify job discrimination by company recruiters against childhood cancer survivors in Japan.

Methods:  We conducted a cross-sectional study using a mailed questionnaire for the Japanese companies that were divided into three groups: companies listed on the stock market, companies not listed on the stock market, and public offices. We randomly selected 2000 of the 4000 listed companies and 2500 of the 4300 unlisted companies. We selected 47 public offices from prefectures and 17 from government ordinance-designated cities. Outcomes were health certificate requirements, how to treat past medical history and present illness, childhood cancer survivors' employment experience, and company's policy for evaluating applicants based on past medical history and present illness.

Results:  Response rates were 17.7% for listed companies, 28.9% for unlisted companies, and 56.3% for public offices. A health certificate was required by 86% of listed companies, 77% of unlisted companies, and 75% of public offices. However, 33% of listed companies and 36% of unlisted companies, and none of the public offices demanded it at the time of application. Small numbers of private companies (0.7% of listed companies and 1.0% of unlisted companies) and public offices (4%) reject applicants outright if they have a disease in their past medical history. Using multivariate analysis, we found that large companies and company policies were significantly associated with the demand for a health certificate at the time of job applications.

Conclusions:  In Japan, employment-related discrimination still occurs in a small number of companies and public offices.