[Cancer treatment situation in Japan with regard to the type of medical facility using medical claim data of Health Insurance Societies].
OBJECTIVE
Analyzing the cancer treatment situation in Japan is an important public health issue, especially because of increasing crude cancer morbidity in a rapidly aging society. This study aimed to examine where cancer patients received treatment, with special attention to designated regional cancer hospitals, and the treatment modality they received.


METHODS
Using health insurance claim data (1,064,875 subjects on December 2011) managed by the Japan Medical Data Center, we included patients that received treatments for stomach, colon, liver, lung, or breast cancer, the most common cancers in Japan, between 2005 and 2011. We divided the medical facilities where they were treated into five groups: prefectural designated regional cancer hospitals, local designated regional cancer hospitals, large/medium hospitals (≥100 beds), small hospitals (20-99 beds), and clinics (0-19 beds). We calculated the percentage of patients treated at each type of medical facility with different treatment modalities.


RESULTS
The study included 2,901 patients. In total, 43.9% patients were treated at designated regional cancer hospitals (prefectural or local). This percentage was the highest for lung cancer (60.0%) and the lowest for colon cancer (31.3%). Surgeries for liver cancer (67.6%) and lung cancer (61.9%) were performed more at designated regional cancer hospitals (prefectural or local) than surgeries for stomach cancer (45.5%), colon cancer (40.1%), and breast cancer (49.8%). Some procedures were performed at small hospitals or clinics (surgery for stomach cancer [9.4%], surgery for breast cancer [9.3%], endoscopic procedures for stomach cancer [14.1%] and colon cancer [40.6%], and chemotherapy for breast cancer [11.4%]). Colon and breast cancer patients treated at prefectural designated regional cancer hospitals or clinics were younger than those treated at other types of facilities.


CONCLUSIONS
The distribution of facilities at which cancer patients received treatment differed significantly according to cancer site, treatment modality, and patient age.
Department of Public Health and Health Policy, Graduate School of Medicine, The University of Tokyo.
Hirokazu
H
Tanaka
Fumiaki
F
Nakamura
Takahiro
T
Higashi
Yasuki
Y
Kobayashi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006761:Hospitals; D006801:Humans; D007348:Insurance, Health; D007564:Japan; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*