Evaluating Behavioral Impacts of School Cancer Education Programs Several Months and Years After Implementation in Japan.

School-based cancer education programs have recently been introduced in Japan to promote cancer awareness and encourage students to value their health and lives. Although short-term behavioral effects have been reported, their long-term effects remain unclear. We evaluated the mid- and long-term effects of a cancer education program conducted in rural Japanese high schools between 2016 and 2019. The program featured lectures by an oncologist and a cancer survivor. In total, 741 former students from four participating schools were invited to complete an online survey. Participants were grouped by their memory of the program: "no memory of the program," "no memory of the contents," and "memory of the contents." Data on human papillomavirus (HPV) vaccination during school days, cervical cancer screening, intention to undergo cancer screening, and health literacy were collected and analyzed. Valid responses were obtained from 96 participants with an average age of 24.1 years. Female participants with a vivid memory of the program were significantly more likely to have received the HPV vaccine (100%) than those without such a memory (63.5%, p = 0.047). However, no significant associations were found between memory of the program and cervical cancer screening behavior or future screening intentions. School-based cancer education may influence HPV vaccination behavior on a several-month timescale but appears to have limited effects on long-term cancer prevention behavior. The program content may need to be optimized to enhance medium-term behavioral changes.