Annual Report 2018
Division of Medical Support and Partnership
Masashi Kato, 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, Mamiko Maeshima, Mika Mizumoto, Yuri Yamauchi
Introduction
The Division enhances partnerships among designated cancer hospitals to support all health-related professionals concerned with cancer control in Japan. The Medical Support and Partnership Section (MSPS) plays a unique role in supporting designated cancer hospitals in Japan. The Pathology Consultation Section (PCS) aims to perform human pathology research based on the histology of tumor cells and tumorstromal cells to improve diagnostic pathology of the tumors. The Radiology Consultation Section (RCS) provides a consultation service and a cancer image reference database (NCCCIR). 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 pathology. The Outreach Radiation Oncology and Physics section (ORP) 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 the role of planning and managing specialized and multidisciplinary training programs for 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 is based on the Basic Cancer Control Plan issued in 2017.
Table 1. Training programs conducted from April 2018 to March 2019
The Team and What We Do
1. A. Networking among Designated Cancer Care Hospitals
The MSPS held the designated cancer hospitals liaison council and the palliative care committee to enhance partnerships for cancer control, and the PDCA Cycle Forum to improve the quality of cancer care in Japan.
2. Pathology consultation service
The PCS received 603 cases requesting a specialist's second opinion regarding histopathological diagnosis (2018.4. - 2019.3.). There are 90 consultants registered, many of them highly recognized experts in specialty disciplines. One of them assigned as a consultant examines the 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
Nine consultation reports have been put together for requests mainly from the Kanto region. Hepato-biliary-pancreatic and central nervous system lesions were the common subjects. Consultation with a specialist was the most frequent reason (39.0%) for consultation. The client radiologists have evaluated 534 (91.1%) of the 586 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, and 303 cases showed signs of cancer.
5. Radiotherapy case service
Mailed dosimetry and on-site dosimetry were performed in 152 institutions and one institution, respectively, at the ORP. All data of the institutions were within the permissible limit.
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) in municipalities. The CSMS also evaluated process indicators such as the workup rate and ranked those indicators in all cities by prefecture in order of goodness so that each city compares its indicators with those of other cities.
2) The CSMS examined the method of activating QA by prefectural initiatives and set up the website as a tool which supports prefectural activity. In 2018, 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-oflife care from bereaved family members.
2. Development of the IMRT quality control support program
The ORP are developing enforcement of the mailed dosimetry regarding the output dose of Intensity Modulated Radiotherapy (IMRT) in two 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 and, summarized it as the national cancer screening implementation status data book < 2018 > and returned these evaluations.
Clinical trials
1. Support for clinical trials
To support central radiological reviews in clinical trials, we have provided a system for receiving and sending DICOM imaging data between participating multi-centers and review boards since 2014. Nine clinical trials used this system in 2018.
2. The on-site dosimetry regarding the output dose of IMRT
In Japan Clinical Oncology Group (JCOG1008, 1208, 1212, 1303, 1402, 1408), the ORP performed postal dosimetry regarding the output dose of IMRT in 18 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. Community-based palliative care resources optimizer education, a project commissioned by the Ministry of Health, Labour and Welfare from 2016, is a unique program for health-related professionals who work towards palliative care collaboration in the community. The CSMS conducted training workshops for cancer workers in prefectures and municipalities. In addition, we provided guidance separately to prefectures where we requested such guidance.
Future prospects
The MSPS will continuously 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 measures, as well as quality control based on the actual understanding of cancer screening in occupational screening, and aims to conduct organized screening throughout the whole country. All sections will continue to be involved in our routine activities and education.
List of papers published in 2018
Journal
1. Takeuchi E, Shimizu M, Miyata K, Shimizu R, Matsunaga N, Moroi N, Fujisawa D, Mimura M, Kato M. A Content Analysis of Multidimensional Support Needs Regarding Fertility Among Cancer Patients: How Can Nonphysician Health Care Providers Support? J Adolesc Young Adult Oncol, 8:205-211, 2019
2. Sagawa M, Machii R, Nakayama T, Sugawara T, Ishibashi N, Mitomo H, Kondo T, Tabata T. The Prefectural Participation Rates of Lung Cancer Screening Had a Negative Correlation with the Lung Cancer Mortality Rates. Asian Pac J Cancer Prev, 20:855- 861, 2019
3. 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
4. Sakashita A, Kizawa Y, Kato M, Akizuki N, Nakazawa Y, Kaizu M, Yano K, Sato T, Tokoro A. Development of a Standard for Hospital- Based Palliative Care Consultation Teams in Japan Using a Modified Delphi Method. J Pain Symptom Manage, 56:746-751. e5, 2018
5. 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, 26:3447-3452, 2018
6. Machii R, Saika K, Kasuya K, Takahashi H, Saito H. Trnds in the quality assurance process indicators for Japanese colorectal cancer screening during 2003-13. Jpn J Clin Oncol, 48:329-334, 2018
7. Morisada T, Saika K, Saito E, Kono K, Saito H, Aoki D. Population- based cohort study assessing the efficacy of cervical cytology (Pap smear) and human papillomavirus (HPV) testing as modalities for cervical cancer screening. Jpn J Clin Oncol, 48:495- 498, 2018
8. Matsuda T, Saika K. Cancer burden in Japan based on the latest cancer statistics: need for evidence-based cancer control programs. Ann Cancer Epidemiol, 2:1-15, 2018
9. Matsuda A, Saika K, Tanaka R, Ito Y, Fukui K, Kamo KI. Simulation Models in Gastric Cancer Screening: A Systematic Review. Asian Pac J Cancer Prev, 19:3321-3334, 2018
10. Yoshida S, Ogawa C, Shimizu K, Kobayashi M, Inoguchi H, Oshima Y, Dotani C, Nakahara R, Kato M. Japanese physicians' attitudes toward end-of-life discussion with pediatric patients with cancer. Support Care Cancer, 26:3861-3871, 2018
11. Kumazaki Y, Ozawa S, Nakamura M, Kito S, Minemura T, Tachibana H, Nishio T, Ishikura S, Nishimura Y. An end-to-end postal audit test to examine the coincidence between the imaging isocenter and treatment beam isocenter of the IGRT linac system for Japan Clinical Oncology Group (JCOG) clinical trials. Phys Med, 53:145-152, 2018
12. Saika K, Machii R. Prostate cancer incidence rates in the world from the Cancer Incidence in Five Continents XI. Jpn J Clin Oncol, 48:783-784, 2018
13. Okuyama A, Saika K. Pancreas cancer incidence rates in the world from the Cancer Incidence in Five Continents XI. Jpn J Clin Oncol, 48:1028-1029, 2018