Shimadzu Kato Mizuki, Morishima Toshitaka, Sakaniwa Ryoto, Nakata Kayo, Kuwabara Yoshihiro, Ikawa Toshiki, Iwaki Yoko, Miyashiro Isao
Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan.
Department of Oncology, Graduate School of Medicine, Osaka University, Osaka, Japan.
Sci Rep. 2025 Jan 31;15(1):3854. doi: 10.1038/s41598-025-88052-x.
The variation in survival rates among patients with cancer based on residential areas has become a significant concern globally. Japan's Basic Plan to Promote Cancer Control Programs (BPPCCP), implemented in 2007, aimed to reduce this variation by designating cancer care hospitals in each cancer medical area (CMA) where patients resided. From the Osaka Cancer Registry data, we extracted 407,489 patients aged 15-74 years with cancer who received treatment in Osaka Prefecture between 1997 and 2015 and analyzed regional variations in survival rates for each patient's residential CMA before and after the implementation of the BPPCCP. By standardizing the distribution of the patients' background factors (sex, age, stage, and socioeconomic status) to the distribution of the whole prefecture, 5-year relative survival rates for each CMA were calculated, and regional variations were assessed. Before BPPCCP, survival variation reached 2.00 percentage points (p-values < 0.05); post-BPPCCP, it decreased to 0.98 percentage points and was no longer significant. In conclusion, the introduction of the BPPCCP in 2007 may have reduced regional variation in the survival rate of patients with cancer in Osaka Prefecture. Measures such as the BPPCCP could potentially equalize the cancer care delivery system.
基于居住地区的癌症患者生存率差异已成为全球关注的重要问题。日本于2007年实施的《促进癌症控制计划基本方案》（BPPCCP）旨在通过在患者居住的每个癌症医疗区域（CMA）指定癌症护理医院来减少这种差异。我们从大阪癌症登记数据中提取了1997年至2015年间在大阪府接受治疗的407,489名15 - 74岁的癌症患者，并分析了BPPCCP实施前后每个患者居住CMA的生存率区域差异。通过将患者背景因素（性别、年龄、阶段和社会经济地位）的分布标准化到整个府的分布，计算了每个CMA的5年相对生存率，并评估了区域差异。在BPPCCP之前，生存率差异达到2.00个百分点（p值<0.05）；在BPPCCP之后，差异降至0.98个百分点且不再显著。总之，2007年引入BPPCCP可能降低了大阪府癌症患者生存率的区域差异。像BPPCCP这样的措施可能会使癌症护理提供系统更加均衡。
