論文の公開元へTrends of travel burdens to access cancer care among children with cancer: analysis of a population-based cancer registry data in Aichi, Japan
概要
Cancer in children who are < 15 years is a rare occurrence worldwide. The estimated agestandardized incidence rate per million person-years was 140.6 worldwide and 126.8 in Japan.1,2
Due to the rarity of cancer in children, the number of cases treated at each hospital tends to be
small. Therefore, cancer treatment ideally should be centralized in specialized childhood cancer
centers that can provide state-of-the-art care for better outcomes.3-5 This treatment centralization
has been promoted globally for children with cancer, and multiple studies have reported the
situations in the United States and European countries.3,6,7 However, centralization may force
patients and families to travel for a long duration and distance and thereby face problems related
to prolonged travel.8
Under the Japanese universal healthcare insurance system and the provision of free access
to healthcare, there existed a concern that many hospitals treat only a handful of new cases
a year and thus may not be capable of providing state-of-the-art care.9 However, as part of
Japan’s cancer-control measures, the specific goal for children with cancer was specified in the
second phase of the Basic Plan to Promote Cancer Control Program in 2012, and in 2013, 15
hospitals were designated as childhood cancer hub hospitals. In 2014, a Japanese questionnaire
survey-based study reported that the majority of parents of children with cancer felt positive
about treatment centralization but found it unacceptable to travel more than an hour each way
for hospitalization and clinic visits.9 Travel time will be considered one of the key concerns for
treatment centralization. However, the actual burden of travel duration and distances to access the
hospitals for children with cancer in Japan, based on registry data, has not been evaluated. It is
also unclear whether the travel burden increased after the childhood cancer hub hospitals were
designated. Therefore, the long-term trend of travel burden should be investigated to understand
the impact of travel burden.
This study aimed to investigate the 20-year trend in travel burden of driving travel times and
distances to access the hospitals for children with cancer, based on data from a population-based
cancer registry (PBCR) in the Aichi Prefecture, Japan, considering the influence of treatmentcentralization measures since the early 2010s. ...
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