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Although research has shown that centenarians tend to experience shorter periods of serious illness compared with other age groups, few studies have focused on the medical expenditures of centenarians as a potential indicator of the scale of medical resources used in their last year of life. To compare Japanese centenarians' and noncentenarians' monthly medical expenditures during the year before death according to age and sex. This retrospective cohort study used linked national health and long-term care insurance data collected from