Annual Report 2020
Center for Cancer Registries
Takahiro Higashi, Naoyuki Sato, Hiroshi Nishimoto, Tomohiro Matsuda, Akiko Shibata, Mariko Niino, Ayako Okuyama, Riko Makoshi, Yoichiro Tsukada, Yoshiko Emori, Mika Mizuochi, Yuka Takahashi, Saya Maruyama, Seiya Kondo, Mika Maeda, Manami Fujishita, Naoki Sakakibara, Shiho Matsuura, Kayoko Kobayashi, Emiko Enjoji, Makiko Inoue, Kana Ujiie, Naoko Takahashi, Saori Uenishi, Mari Watabe and Tomoko Kobayashi
Introduction
The Center for Cancer Registries is in charge of operating public cancer registries to provide the public with accurate cancer incidence and survival statistics. The Center operates population-based cancer registries (the National Cancer Registry) and hospital-based cancer registries according to new legislation, the Cancer Registry Promotion Act.
The Team and What We Do
1. Population-Based Cancer Registries
The Cancer Registry Promotion Act of 2013 created a new structure called the National Cancer Registry, which mandates that all hospitals in Japan submit basic data to prefectures when they diagnose new patients with cancer. The Center developed an online National Cancer Registry System (NCRS), through which we collect this information from the 47 prefectures. The system started in 2016, and we reported national incidence rates in 2018 to the Ministry of Health, Labour and Welfare (MHLW). We have also started a data use service for research purposes in 2018, and 21 researchers were provided an individual dataset in 2020.
We closely communicate with the prefectures and continuously strive to improve our cancer surveillance system in Japan by holding remote educational workshops for cancer registrars and administrative officers of prefectures overseeing cancer control in May (120 participants) and December (136 participants). The Population-Based Cancer Registry Database System (PBCRDS), owned by the Center, enables the prefectures to maintain cancer registry data for past years and to link them with the current data in the NCRS. Forty-five registries have introduced the PBCRDS as of March 2021. An external audit on information security in cancer registration was performed by commissioning the cancer registry professional organization. The Center distributes a simplified cancer registry system, “Hos-CanR Lite” to hospitals that submit dates only to the National Cancer Registry.
Table 1. Cancer Patient Data in Hospital-Based Cancer Registries
2. Hospital-Based Cancer Registries
The Hospital-Based Cancer Registry (HBCR) has become a key component in evaluating cancer care in hospitals and has also provided a data frame for population-based registries. Once submitted directly to the Center, the HBCR data help form a national database of hospital-based cancer registries and generate national cancer statistics geared more towards clinical aspects than population-based cancer registries. The Cancer Registry Promotion Act encourages hospitals specialized in cancer care or those playing key roles in the region to operate the HBCR in accordance with the National Guidelines. The National Guidelines state that the Center should set the standards for the HBCR nationwide and produce the national statistics for cancer care so that the patients can choose hospitals and the government can enhance cancer control activities. The HBCR has been performed at 436 designated cancer care hospitals (DCCHs) and 336 others, including 15 designated hospitals for pediatric cancer. Individual records for 1,039,193 cancer cases diagnosed in 2018 were collected from 828 hospitals. To implement the 8th edition of the newly published UICC TNM classification rules and the latest version of the SEER multiple primary rules, the Center convened several expert committee meetings to define the detailed rules and standards for the HBCR and educate cancer registrars at the hospitals. We then updated and distributed the standardized software "Hos-CanR Next" to incorporate these changes.
To ensure data quality, we organized a series of education programs for cancer registrars. Approximately 2 hours of e-learning training was conducted for those certified as beginner or intermediate cancer registrars, and 805 and 691 individuals participated in the training sessions, respectively. A total of 349 individuals took the renewal examination for beginners, with 334 passing, and 230 individuals took the renewal examination for the intermediate level, with 218 passing.
In addition, freely viewable e-learning videos were provided to those intending to obtain the beginner certification in cancer registration practice, and 675 individuals were certified through the beginner certification exam. In addition, an 18-hour e-learning training course was provided for those seeking intermediate-level certification. Of the 195 individuals participating in the training session, 177 were certified through the intermediate level certification examination.
In addition, an online training program for data analysis for cancer registrars was held.
Research activities
The national cancer survival statistics for 2009-2011 were calculated based on the data from 22 prefectural population-based cancer registries. The incidence data from 2017 were published based on the National Cancer Registry, which covers all 47 prefectures, and was analyzed in detail according to cancer site and age group. The results were published in international academic journals, presented at conferences both in Japan and abroad, and posted on the website in a national report, "Cancer Statistics of Japan".
As a routine activity, international comparisons of cancer burden and survival rates were conducted based on WHO mortality, GLOBOCAN and the cancer registry database. An updated trend analysis of cancer incidence and mortality in Japan was conducted.
Hospital-based cancer registries are compiled at the national level in the Center. To improve the quality of cancer care nationwide, we produced an annual report for cases diagnosed in 2018. In addition, we developed a web system to determine the number of registered cases in each hospital based on Hospital-Based Cancer Registry data, which can help patients or their families to find a hospital near their home.
The national database was used extensively in research activities both within and outside the Center, while the Secondary Data Use Review Committee approved six proposals for data use.
Education
Prefectural cancer registry personnel and hospital-based cancer registrars were trained as mentioned above; in particular, the Center collaborated closely with NCC hospitals to educate intermediate-level cancer registrars.
Future Prospects
We plan activities to improve the operation of the National Cancer Registry (NCR) on an ongoing basis. Working with the National Cancer Center’s International Affairs Section, the Center is building a relationship with the International Agency of Research on Cancer (IARC) and other international institutions based on the bi-institutional memorandum of understanding.
The hospital-based cancer registries continue to evolve and close monitoring of the care provided to cancer patients in Japan enables better access to quality care. To enable cancer patients and their families to efficiently access the hospital information they need, an interactive website was launched showing the number of cases involved in each patient’s treatment. The data are used for all aspects of cancer control activities, including hospital designation, organization of a care structure for rare cancer patients and quality monitoring of care.
List of papers published in 2020
Journal
1. Katanoda K, Hori M, Saito E, Shibata A, Ito Y, Minami T, Ikeda S, Suzuki T, Matsuda T. Updated trends in cancer in Japan: incidence in 1985-2015 and mortality in 1958-2018 - a sign of decrease in cancer incidence. J Epidemiol, 2021
2. Nagumo Y, Kawai K, Kojima T, Shiga M, Kojo K, Tanaka K, Kandori S, Kimura T, Kawahara T, Okuyama A, Higashi T, Nishiyama H. Prognostic impact of non-urothelial carcinoma of the upper urinary tract: Analysis of hospital-based cancer registry data in Japan. Int J Urol, 28:54-60, 2021
3. Aogi K, Takeuchi H, Saeki T, Aiba K, Tamura K, Iino K, Imamura CK, Okita K, Kagami Y, Tanaka R, Nakagawa K, Fujii H, Boku N, Wada M, Akechi T, Iihara H, Ohtani S, Okuyama A, Ozawa K, Kim YI, Sasaki H, Shima Y, Takeda M, Nagasaki E, Nishidate T, Higashi T, Hirata K. Optimizing antiemetic treatment for chemotherapy-induced nausea and vomiting in Japan: Update summary of the 2015 Japan Society of Clinical Oncology Clinical Practice Guidelines for Antiemesis. Int J Clin Oncol, 26:1-17, 2021
4. Okuyama A, Hori M. Age-specific bladder cancer incidence rate in the world. Jpn J Clin Oncol, 51:511-512, 2021
5. Usui Y, Ito H, Koyanagi Y, Shibata A, Matsuda T, Katanoda K, Maeda Y, Matsuo K. Changing trend in mortality rate of multiple myeloma after introduction of novel agents: A population-based study. Int J Cancer, 147:3102-3109, 2020
6. Okuyama A, Matsuda T. Age-specific lung cancer incidence rate in the world. Jpn J Clin Oncol, 50:836-837, 2020
7. Hori M, Okuyama A. Age-specific incidence rates of stomach cancer in the world. Jpn J Clin Oncol, 50:724-725, 2020
8. Kojo K, Kawai K, Kawahara T, Kimura T, Kandori S, Nagumo Y, Nitta S, Kojima T, Okuyama A, Higashi T, Nishiyama H. Recent malignant testicular tumor trend in Japan, a country with an aging population: a large-scale study of 2012-2015 hospital-based cancer registry data. Jpn J Clin Oncol, 50:1201-1208, 2020
9. Tanaka K, Kandori S, Nitta S, Chihara I, Kojo K, Nagumo Y, Kimura T, Kojima T, Kawai K, Okuyama A, Higashi T, Nishiyama H. Characteristics of penile cancer in Japan: An analysis of nationwide hospital-based cancer registry data. Int J Urol, 27:538-542, 2020
10. Kimura T, Kawai K, Kandori S, Nitta S, Kojo K, Nagumo Y, Negoro H, Okuyama A, Higashi T, Kojima T, Nishiyama H. Impact of centralization in primary retroperitoneal sarcoma treatment: analysis using hospital-based cancer registry data in Japan. Int J Clin Oncol, 25:1687-1694, 2020
11. Shibata A, Saji S, Kamiya K, Yasumura S. Trend in Cancer incidence and mortality in Fukushima between 2008 and 2015. J Epidemiol, 2020
12. Nagumo Y, Kawai K, Kojima T, Shiga M, Kojo K, Tanaka K, Kandori S, Kimura T, Kawahara T, Okuyama A, Higashi T, Nishiyama H. Prognostic significance of non-urothelial carcinoma of bladder: analysis of nationwide hospital-based cancer registry data in Japan. Jpn J Clin Oncol, 50:1068-1075, 2020
13. Okuyama A. Commentary on Speaking Up About Patient Safety in Perioperative Care: Differences Between Academic and Non-academic Hospitals in Austria and Switzerland. J Invest Surg, 33:739-740, 2020