Annual Report 2017
Division of Medical Support and Partnership
Masashi Kato, Yasuaki Arai, Jun Itami, Nobuyoshi Hiraoka, Hirokazu Takahashi, Hironobu Hashimoto, Mayumi Tsukagoshi, Toshiyuki Minemura, Yoko Nakazawa, Manami Fujishita, Kumiko Saika, Ryoko Machii, Takashi Hanada, Yoshiko Yamaya, Emi Takeuchi, Risa Yamazaki, Kazuko Matsuda, Kaishi Satomi, Chieko Nagashima, Takatsugu Magara, Naoya Ikeno, Hiroaki Onoya, Saran Yoshida, Hideaki Kobayashi, Miki Takahashi, Hiroyo Ohchi, Mayumi Kobayashi, Ritsuko Chinda, Hiromi Nakamura, Shiho Hirai, Mika Mizumoto, Yuri Yamauchi
Introduction
The Division of Medical Support and Partnership enhances partnership among designated cancer hospitals to support all allied health professionals concerned with cancer control in Japan. The Medical Support and Partnership Section (MSPS) plays a unique role in supporting Designated Cancer Care Hospitals in Japan. The Pathology Consultation Section (PCS) makes effort to perform human pathology research based on histology of tumor cells and tumor-stromal cells to improve diagnostic pathology of tumors. The Radiology Consultation Section (RCS) provides a consultation service and a cancer image reference database (NCC-CIR). A radiology consultation service is aimed at the improvement of the quality of diagnosis based on medical images. The NCC-CIR is a web-based reference database system of images of neoplasms for physicians, radiologists, and pathologists, providing medical diagnostic images and information together with the pathology. The Outreach Radiation Oncology and Physics Section (ORPS) provides the following support programs for designated regional cancer centers and institutions participating in clinical trials. The Cancer Control Education and Training Section (CCETS) plays a central role in the planning and managing specialized and multidisciplinary training programs for allied health professionals in designated cancer hospitals, to promote a comprehensive and systematic cancer control program in Japan. The Cancer Screening Management Section (CSMS) supports the development of quality assurance management of cancer screening programs, particularly nationwide programs, which are based on the Basic Cancer Control Plan issued in 2017.
Our team and what we do
1. Networking among Designated Cancer Care Hospitals
The MSPS held the designated cancer hospitals liaison-council and the palliative care committee to enhance partnership for cancer control, and the PDCA cycle Forum to improve the quality of cancer care in Japan.
2. Pathology consultation service
The PCS received 587 cases requesting a specialist's second opinion regarding histopathologicaldiagnosis (2017.1. ‐ 2018.3.). There are 94 consultants registered, many of them highly recognized experts in specialty disciplines. One of them assigned as a consultant examines slides and quickly sends back his or her opinion report to each client. Most of the clients expressed satisfaction with the contents of the report and this consultation system. We also selected typical or educational cases from accumulated archives and constructed a referential database.
3. Radiology consultation service
Twenty-eight consultation reports have been put together for requests mainly from the Kanto and Chugoku regions. Hepatobiliary-pancreatic and musculoskeletal lesions were the common subjects. Consultation with a specialist was the most frequent reason (39.1%) for consultation. The client radiologists have evaluated 524 (91.1%) of the 575 consultation reports as being useful for the presence of clinical impact on the final radiological diagnoses.
4. NCC-CIR
The average number of effective accesses to this site was almost the same as that in 2016, about 100,000 per month, with 303 cases of cancer shown.
5. Radiotherapy case service
The ORPS provides the following support programs for designated regional cancer centers and institutions participating in clinical trials.
6. Quality assurance (QA) activities in cancer screening
1) The CSMS collected the information related to the implementation of cancer screening and its management situation using Checklists (CLs) as a structure indicator in quality assurance (QA) at municipalities. The CSMS also evaluated process indicators such as a rate of the workup, and ranked those indicators in all cities by prefecture in order of goodness so that each city compares its indicator with those of other cities.
2) The CSMS examined the method of activating QA by prefectural initiative and set up the website as a tool which supports prefectural activity. In 2017, a prefecture-based database about CLs and process indicators, and the manual of QA for prefectural staff were placed on the website.
Research activities
1. The National Mortality follow back survey
The MSPS conducted a feasibility study of the Population-based mortality follow-back survey to collect information concerning end-of-life care from bereaved family members.
2. Development of the IMRT quality control support program
The ORPS was developing enforcement of the mailed dosimetry regarding the output dose of Intensity Modulated Radiotherapy (IMRT) in five institutions (designated regional cancer centers).
3. National cancer screening implementation status survey
The CSMS surveyed and analyzed the implementation status of cancer screening (screening contents and QA level) in prefectures and municipalities, furthermore summarized it as National cancer screening implementation status data book <2017> and returned these evaluations. In addition, we updated manual of cancer screening quality assurance for municipal officials and released it as the second edition.
Clinical trials
1. Support for clinical trials
To support central radiological review in clinical trials, we have provided a system for receiving and sending DICOM imaging data between participating multi-centers and the review board since 2014. Nine clinical trials used this system in 2017.
2. The on-site dosimetry regarding the output dose of IMRT
In Japan Clinical Oncology Group (JCOG 1008, JCOG1208, JCOG1212, JCOG1303, JCOG 1402, and JCOG1408) and the Japanese Radiation Oncology Study Group (JROSG12-1), the ORPS performed on-site dosimetry regarding the output dose of IMRT in 35 institutions.
Education
The CCETS provides and evaluates various oncology professional training programs about chemotherapy, palliative care, nursing care for nurses, pharmacists, and so on. The CCETS provides multidisciplinary training programs for Palliative Care Teams and Chemotherapy Teams. The CSMS conducted training workshops for cancer workers in prefectures, municipalities. In addition, we provided guidance separately to prefectures where we requested.
Future prospects
The MSPS will conduct the National Mortality follow back survey targeting about 50,000 bereaved families. The CSMS continues implementation, surveillance, and support of cancer screening conducted by municipalities according to National cancer control and Cancer screening measure, as well as quality control based on the actual grasp of cancer screening in occupational screening, and aims to conduct an organized screening in the whole country. All sections will continue to be involved in our routine activities and education.
Table 1. Training programs conducted from April 2017 to March 2018
Table 1. Training programs conducted from April 2017 to March 2018
List of papers published in January 2017 - March 2018
Journal
1. Machii R, Saika K. The estimates of 5-year uterus cancer prevalence in adult population in 2012. Jpn J Clin Oncol, 47:1103-1104, 2017
2. Okamoto H, Nakamura S, Nishioka S, Iijima K, Wakita A, Abe Y, Tohyama N, Kawamura S, Minemura T, Itami J. Independent assessment of source position for gynecological applicator in high-dose-rate brachytherapy. Journal of contemporary brachytherapy, 9:477-486, 2017
3. Machii R, Saika K. Incidence rate for larynx cancer in Japanese in Japan and in the United States from the Cancer Incidence in Five Continents. Jpn J Clin Oncol, 47:471-472, 2017
4. Okuyama A, Saika K. The estimates of 5-year stomach cancer prevalence in adult population in 2012. Jpn J Clin Oncol, 47:777-778, 2017
5. Miyoshi Y, Yorifuji T, Horikawa R, Takahashi I, Nagasaki K, Ishiguro H, Fujiwara I, Ito J, Oba M, Fujisaki H, Kato M, Shimizu C, Kato T, Matsumoto K, Sago H, Takimoto T, Okada H, Suzuki N, Yokoya S, Ogata T, Ozono K. Childbirth and fertility preservation in childhood and adolescent cancer patients: a second national survey of Japanese pediatric endocrinologists. Clinical pediatric endocrinology : case reports and clinical investigations, 26:81-88, 2017
6. Saika K, Matsuda T. The estimates of 5-year cancer prevalence in adult population in 2012. Jpn J Clin Oncol, 47:581-582, 2017
7. Takeuchi E, Kato M, Miyata K, Suzuki N, Shimizu C, Okada H, Matsunaga N, Shimizu M, Moroi N, Fujisawa D, Mimura M, Miyoshi Y. The effects of an educational program for non-physician health care providers regarding fertility preservation. Support Care Cancer, 2018
8. Okamoto H, Minemura T, Nakamura M, Mizuno H, Tohyama N, Nishio T, Wakita A, Nakamura S, Nishioka S, Iijima K, Fujiyama D, Itami J, Nishimura Y. Establishment of postal audit system in intensity-modulated radiotherapy by radiophotoluminescent glass dosimeters and a radiochromic film. Phys Med, 48:119-126, 2018
9. Saika K, Matsuda T. Cancer incidence rates in the world from the Cancer Incidence in Five Continents XI. Jpn J Clin Oncol, 48:98-99, 2018
10. Machii R, Saika K, Kasuya K, Takahashi H, Saito H. Trends in the quality assurance process indicators for Japanese colorectal cancer screening during 2003-13. Jpn J Clin Oncol, 48:329-334, 2018
11. Nakazawa Y, Kato M, Miyashita M, Morita T, Kizawa Y. Changes in Nurses' Knowledge, Difficulties, and Self-reported Practices Toward Palliative Care for Cancer Patients in Japan: An Analysis of Two Nationwide Representative Surveys in 2008 and 2015. J Pain Symptom Manage, 55:402-412, 2018
12. Nakazawa Y, Yamamoto R, Kato M, Miyashita M, Kizawa Y, Morita T. Improved knowledge of and difficulties in palliative care among physicians during 2008 and 2015 in Japan: Association with a nationwide palliative care education program. Cancer, 124:626-635, 2018