{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T21:29:23Z","timestamp":1775597363830,"version":"3.50.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"AstraZeneca K.K."}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Breast Cancer"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Since 2007, the Basic Plans for Promoting Cancer Control (BPPCCs) have sought to enhance cancer care at designated cancer care hospitals (DCCHs) and implement population (PBCR)- and hospital (HBCR)-based cancer registries, among other activities. However, the impact of the BPPCCs on breast cancer care in Japan remains uncertain. This study sought to reveal the reality of regional disparities in the proportion of breast cancer patients' initial visits to DCCHs and the functionality of breast cancer in DCCHs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We obtained data from the PBCR and HBCR in Japan, as well as administrative healthcare claims data (JMDC claims data), and data published by clinical societies in Japan for the period 2018 to 2021. We conducted descriptive analyses to determine the proportions of patients who received initial treatment for breast cancer at a DCCH. We also examined the quality of care in terms of staffing and functions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>In 2020, out of 79,062 breast cancer patients registered in the HBCR, 57.7% started initial treatment at a DCCH (range across 47 prefectures: 15.5%\u201389.8%) in Japan. The proportion of patients who visited a DCCH for initial treatment increased from 53.8% (2018) to 57.7% (2020). The median proportion of DCCHs certified by the Japanese Breast Cancer Society (JBCS) among the 47 prefectures was 62.50% (range: 16.7%\u2013100.0%). The median number of patients per JBCS-certified specialist was 77.40 (range: 37.6\u2013142.0). The proportions of DCCHs with claims for breast cancer-related service fees were 15.2% (range: 0.0%\u201350.0%) for cancer genome profiling tests, 62.0% (range: 0.0%\u2013100.0%) for cancer <jats:italic>BRCA1\/2<\/jats:italic> genetic tests, and 92.8% (range:\u00a060.0%\u2013100.0%) for patient support system enhancement.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>We found regional disparities in the initial treatment and medical services for breast cancer care in Japan. The findings uncover opportunities to enhance the treatment of breast cancer in Japan. We anticipate that our data will be utilized as a valuable resource and as a key input for informing policy development tailored to the specific characteristics of the region and for designing programs to address the different needs of each prefecture.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s12282-025-01739-x","type":"journal-article","created":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T20:42:36Z","timestamp":1754167356000},"page":"1102-1114","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Regional disparities in breast cancer healthcare in Japan: REAL-BC study"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8039-1213","authenticated-orcid":false,"given":"Hiroshi","family":"Kitagawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuki","family":"Fukuzawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,2]]},"reference":[{"key":"1739_CR1","unstructured":"Ministry of Health, Labour and Welfare. Trends in leading causes of death. Summary of vital statistics in Japan, 2022. Available at: https:\/\/www.mhlw.go.jp\/english\/database\/dbhw\/populate\/dl\/E03.pdf. Accessed: July 16, 2024."},{"key":"1739_CR2","unstructured":"Ministry of Health, Labour and Welfare. Comprehensive and well-planned promotion of cancer control. Part 2 key administrative measures of the Ministry of Health, Labour and Welfare in the Annual Health, Labour and Welfare Report 2007\u20132008. Available at: https:\/\/www.mhlw.go.jp\/english\/wp\/wp-hw2\/index.html. Accessed: July 16, 2024."},{"key":"1739_CR3","unstructured":"Ministry of Health, Labour and Welfare. The 3rd-term Basic Plan to Promote Cancer Control Programs. Health and medical services in Annual Health, Labour and Welfare Report 2021. Available at: https:\/\/www.mhlw.go.jp\/english\/wp\/wp-hw14\/dl\/02e.pdf. Accessed: July 16, 2024."},{"issue":"6","key":"1739_CR4","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1093\/jjco\/hyab036","volume":"51","author":"A Okuyama","year":"2021","unstructured":"Okuyama A, Tsukada Y, Higashi T. Coverage of the hospital-based cancer registries and the designated cancer care hospitals in Japan. Jpn J Clin Oncol. 2021;51(6):992\u20138. https:\/\/doi.org\/10.1093\/jjco\/hyab036.","journal-title":"Jpn J Clin Oncol"},{"key":"1739_CR5","unstructured":"Foundation for Promotion of Cancer Research; The editorial board of Cancer Statistics in Japan. Cancer Statistics in Japan 2023. Available at: https:\/\/ganjoho.jp\/public\/qa_links\/report\/statistics\/pdf\/cancer_statistics_2023.pdf. Accessed: July 16, 2024. 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Breast Cancer. 2024;31(3):340\u20136. https:\/\/doi.org\/10.1007\/s12282-024-01566-6.","journal-title":"Breast Cancer"},{"issue":"2","key":"1739_CR8","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/s12282-024-01545-x","volume":"31","author":"T Iwamoto","year":"2024","unstructured":"Iwamoto T, Kumamaru H, Niikura N, Sagara Y, Miyashita M, Konishi T, et al. Survival trends and patient characteristics between 2004 and 2016 for breast cancer in Japan based on the national clinical database-breast cancer registry. Breast Cancer. 2024;31(2):185\u201394. https:\/\/doi.org\/10.1007\/s12282-024-01545-x.","journal-title":"Breast Cancer"},{"issue":"1","key":"1739_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s12282-021-01307-z","volume":"29","author":"D Yotsumoto","year":"2022","unstructured":"Yotsumoto D, Sagara Y, Kumamaru H, Niikura N, Miyata H, Kanbayashi C, et al. Trends in adjuvant therapy after breast-conserving surgery for ductal carcinoma in situ of breast: a retrospective cohort study using the national breast cancer registry of Japan. Breast Cancer. 2022;29(1):1\u20138. https:\/\/doi.org\/10.1007\/s12282-021-01307-z.","journal-title":"Breast Cancer"},{"issue":"2","key":"1739_CR10","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1007\/s10549-023-06917-z","volume":"199","author":"N Narii","year":"2023","unstructured":"Narii N, Zha L, Komatsu M, Kitamura T, Sobue T, Ogawa T. Cholesterol and breast cancer risk: a cohort study using health insurance claims and health checkup databases. Breast Cancer Res Treat. 2023;199(2):315\u201322. https:\/\/doi.org\/10.1007\/s10549-023-06917-z.","journal-title":"Breast Cancer Res Treat"},{"key":"1739_CR11","doi-asserted-by":"publisher","DOI":"10.1200\/go.22.00222","volume":"9","author":"T Ogawa","year":"2023","unstructured":"Ogawa T, Takahashi H, Saito H, Sagawa M, Aoki D, Matsuda K, et al. 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General cancer information. People in rural and remote areas. Available at: https:\/\/www.cancer.nsw.gov.au\/general-cancer-information\/cancer-support\/support-for-communities\/people-in-rural-and-remote-areas. Accessed April 21, 2024."},{"key":"1739_CR15","unstructured":"Breast Cancer Network Australia. Support in rural and regional Australia. Available at: https:\/\/www.bcna.org.au\/resource-hub\/articles\/support-in-rural-and-regional-australia\/. Accessed December 13, 2024."},{"issue":"10","key":"1739_CR16","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1093\/jjco\/hyac129","volume":"52","author":"A Okuyama","year":"2022","unstructured":"Okuyama A, Watabe M, Makoshi R, Takahashi H, Tsukada Y, Higashi T. Impact of the COVID-19 pandemic on the diagnosis of cancer in Japan: analysis of hospital-based cancer registries. Jpn J Clin Oncol. 2022;52(10):1215\u201324. https:\/\/doi.org\/10.1093\/jjco\/hyac129.","journal-title":"Jpn J Clin Oncol"},{"issue":"1","key":"1739_CR17","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1186\/s12885-022-10417-6","volume":"22","author":"T Terashima","year":"2022","unstructured":"Terashima T, Konishi H, Sato Y, Igarashi M, Yanagibashi T, Konno R, et al. Impact of coronavirus disease 2019 on the number of newly diagnosed cancer patients and examinations and surgeries performed for cancer in Japan: a nationwide study. BMC Cancer. 2022;22(1):1303. https:\/\/doi.org\/10.1186\/s12885-022-10417-6.","journal-title":"BMC Cancer"},{"issue":"1","key":"1739_CR18","doi-asserted-by":"publisher","first-page":"94","DOI":"10.31662\/jmaj.2023-0126","volume":"7","author":"S Yamaguchi","year":"2024","unstructured":"Yamaguchi S, Atarashi T, Okada A, Nasu S, Yamauchi T, Arase Y, et al. 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Social Medicine and International Strategy (2023-A-24) Research on the construction of a network of base hospitals to improve the quality of medical care in prefectures. Pre-questionnaire results report. Available at: https:\/\/ganjoho.jp\/med_pro\/vod\/pdca\/forum\/pdf\/2023_jizen1-1.pdf. Accessed: November 5, 2024. In Japanese."},{"key":"1739_CR27","unstructured":"National Cancer Center. Base Hospital Liaison Council. Available at: https:\/\/ganjoho.jp\/med_pro\/liaison_council\/index.html. Accessed: August 5, 2024. In Japanese."},{"key":"1739_CR28","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17020521","author":"A Okuyama","year":"2020","unstructured":"Okuyama A, Higashi T. Usability of clinical information in discharge summary data in the diagnosis procedure combination survey for cancer patients. 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The study was approved by an independent ethics committee (MINS ethics committee; approval number: 240216; date of approval: June 6, 2024).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human participants"}},{"value":"Owing to the retrospective nature of this observational study, and the use of commercially available anonymized administrative data, it was not necessary to obtain informed consent in accordance with Japanese regulations.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}