がんの臨床・疫学・社会的課題の解決のためのがん登録とＤＰＣデータの連結解析

2020 Fiscal Year Research-status Report

• Project/Area Number: 20K18869
• Research Institution: Osaka International Cancer Institute
• Principal Investigator: 森島 敏隆 地方独立行政法人大阪府立病院機構大阪国際がんセンター(研究所), その他部局等, がん対策センター政策情報部副部長 (10728893)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: がん登録 / DPCデータ / リンケージ / リアルワールドデータ / 費用対効果 / 医療の質 / リスク調整 / ヘルスサービスリサーチ

Outline of Annual Research Achievements

近年、保健医療介護分野全体を通して、複数のデータの連結（リンケージ）の必要性が論じられている。データベースを患者個人レベルで突合できれば意味のある情報がつながり、データ解析の幅が格段に広がる。本研究では、がん診断10年後の生死を99%追跡する大阪府がん登録データ（大阪府民の受けたがん診断情報を悉皆的に把握するレジストリ）と院内がん登録データ（がん診療拠点病院が自施設のがん患者・診療情報を整理して把握するためのレジストリ）とDPCデータ（わが国独自の医事管理データの１種）を連結したビッグデータを作成することにした。大阪府内の30以上の施設（すべて厚生労働省または大阪府指定のがん診療拠点病院）から患者個人レベルで連結したデータを提出していただいて、データベースを構築した。
連結データを使って以下のような解析をする。1) がん診療の実態把握、地域／施設間の均てん化の評価と格差に関連する要因の探索、2) がん患者の長期生存率を地域／施設間で公正に比較できるような、ケースミックスの違いを緻密にリスク調整する、患者集団の標準化の手法開発、3) がん診療の均てん化と効率的な医療資源利用を両立する最適な資源配置のあり方の探求、4）がん治療法と生存期間の因果関係を推論するリアルワールド研究。特に、臨床試験の実施が困難な患者集団（希少がん、高齢者、小児・思春期・若年成人、併存疾患を持つ患者等）のための観察研究発のエビデンス創出、5)高額薬剤のリアルワールド費用対効果分析4）がん患者の社会的問題、がんサバイバー・緩和ケア・地域連携の議論に資する資料作成。

Current Status of Research Progress

2: Research has progressed on the whole more than it was originally planned.

Reason

研究協力病院の協力を得て、データベースの構築が順調に進んでいる。また、データの利用・解析も順調に進んでいる。

Strategy for Future Research Activity

様々な分野の専門家とのインタラクションを加速して、社会や診療現場に切実で、かつ学術的にも重要な課題の研究遂行を強化する。国際的な視野も取り入れることによって、わが国のがん医療に内在する問題点を明らかにする。

Causes of Carryover

（理由）
研究成果を発表する学会が近隣府県またはオンラインで行われることが多かったため、旅費が予定より少なくなった。
（使用計画）
研究成果を発表するための学会参加や論文投稿に伴う支出が増加する。

Research Products

• [Int'l Joint Research] Rutgers Institute for Health(米国)
  • Country Name: U.S.A.
  • Counterpart Institution: Rutgers Institute for Health
• [Journal Article] Prognostic Effect of Incidental Pulmonary Embolism on Long-Term Mortality in Cancer Patients (2022)
  • Author(s): Nishikawa Tatsuya、Fujita Takeshi、Morishima Toshitaka、Okawa Sumiyo、Hino Terutaka、Yasui Taku、Shioyama Wataru、Oka Toru、Miyashiro Isao、Fujita Masashi
  • Journal Title: Circulation Journal Volume: 86 Pages: ～
  • DOI: 10.1253/circj.CJ-20-1160
  • Peer Reviewed
• [Journal Article] Comparison of CHOP with THP-COP for peripheral T-cell lymphoma-not otherwise specified and angioimmunoblastic T-cell lymphoma: a retrospective analysis using data from the population-based Osaka Cancer Registry (2021)
  • Author(s): Kida Shuhei、Fuji Shigeo、Morishima Toshitaka、Nakata Kayo、Miyashiro Isao、Ishikawa Jun
  • Journal Title: International Journal of Hematology Volume: 114 Pages: 246～251
  • DOI: 10.1007/s12185-021-03150-6
  • Peer Reviewed
• [Journal Article] Barthel Index-based functional status as a prognostic factor in young and middle-aged adults with newly diagnosed gastric, colorectal and lung cancer: a multicentre retrospective cohort study (2021)
  • Author(s): Morishima Toshitaka、Sato Akira、Nakata Kayo、Matsumoto Yoshifumi、Koeda Nobuyuki、Shimada Hiroko、Maruhama Tsutomu、Matsuki Daisaku、Miyashiro Isao
  • Journal Title: BMJ Open Volume: 11 Pages: e046681～e046681
  • DOI: 10.1136/bmjopen-2020-046681
  • Peer Reviewed / Open Access
• [Journal Article] Multicentre cohort study of the impact of percutaneous coronary intervention on patients with concurrent cancer and ischaemic heart disease (2021)
  • Author(s): Nishikawa Tatsuya、Morishima Toshitaka、Okawa Sumiyo、Fujii Yuki、Otsuka Tomoyuki、Kudo Toshihiro、Fujita Takeshi、Kamada Risa、Yasui Taku、Shioyama Wataru、Oka Toru、Tabuchi Takahiro、Fujita Masashi、Miyashiro Isao
  • Journal Title: BMC Cardiovascular Disorders Volume: 21 Pages: 177～177
  • DOI: 10.1186/s12872-021-01968-w
  • Peer Reviewed / Open Access
• [Journal Article] Increasing trends in the prevalence of prior cancer in newly diagnosed lung, stomach, colorectal, breast, cervical, and corpus uterine cancer patients: a population-based study (2021)
  • Author(s): Sato Akira、Matsubayashi Keisuke、Morishima Toshitaka、Nakata Kayo、Kawakami Koji、Miyashiro Isao
  • Journal Title: BMC Cancer Volume: 21 Pages: 264～264
  • DOI: 10.1186/s12885-021-08011-3
  • Peer Reviewed / Open Access
• [Journal Article] Excessive risk of second-cancer incidence and cancer mortality in patients with esophageal cancer (2021)
  • Author(s): Ohmori Masayasu、Ishihara Ryu、Morishima Toshitaka、Tabuchi Takahiro、Okada Hiroyuki、Ohno Yuko、Sobue Tomotaka、Miyashiro Isao
  • Journal Title: Journal of Gastroenterology Volume: 56 Pages: 434～441
  • DOI: 10.1007/s00535-021-01767-2
  • Peer Reviewed
• [Journal Article] Trends in survival of leukemia among children, adolescents, and young adults: A population‐based study in Osaka, Japan (2021)
  • Author(s): Nakata Kayo、Okawa Sumiyo、Fuji Shigeo、Sato Akira、Morishima Toshitaka、Tada Yuma、Inoue Masami、Hara Junichi、Kawa Keisei、Miyashiro Isao、the Osaka Cancer Association for Children, Adolescents, Young Adults
  • Journal Title: Cancer Science Volume: 112 Pages: 1150～1160
  • DOI: 10.1111/cas.14808
  • Peer Reviewed / Open Access
• [Journal Article] Analysis of real-world data in patients with relapsed/refractory diffuse large B cell lymphoma who received salvage chemotherapy in the rituximab era (2021)
  • Author(s): Fuji Shigeo、Kida Shuhei、Nakata Kayo、Morishima Toshitaka、Miyashiro Isao、Ishikawa Jun
  • Journal Title: Annals of Hematology Volume: 100 Pages: 2253～2260
  • DOI: 10.1007/s00277-020-04342-6
  • Peer Reviewed
• [Journal Article] Increased incidence of adult T cell leukemia-lymphoma and peripheral T cell lymphoma?not otherwise specified with limited improvement in overall survival: a retrospective analysis using data from the population-based Osaka Cancer Registry (2021)
  • Author(s): Fuji Shigeo、Kida Shuhei、Nakata Kayo、Morishima Toshitaka、Miyashiro Isao、Ishikawa Jun
  • Journal Title: Annals of Hematology Volume: 100 Pages: 157～165
  • DOI: 10.1007/s00277-020-04308-8
  • Peer Reviewed
• [Journal Article] Hospital Surgical Volume and 3-Year Mortality in Severe Prognosis Cancers: A Population-Based Study Using Cancer Registry Data (2021)
  • Author(s): Taniyama Yukari、Tabuchi Takahiro、Ohno Yuko、Morishima Toshitaka、Okawa Sumiyo、Koyama Shihoko、Miyashiro Isao
  • Journal Title: Journal of Epidemiology Volume: 31 Pages: 52～58
  • DOI: 10.2188/jea.JE20190242
  • Peer Reviewed / Open Access
• [Journal Article] Three‐year survival from diagnosis in surgically treated patients in designated and non‐designated cancer care hospitals in Japan (2021)
  • Author(s): Okawa Sumiyo、Tabuchi Takahiro、Nakata Kayo、Morishima Toshitaka、Koyama Shihoko、Odani Satomi、Miyashiro Isao
  • Journal Title: Cancer Science Volume: in press Pages: in press
  • DOI: 10.1111/cas.14847
  • Peer Reviewed / Open Access
• [Journal Article] Prognostic impact of cancer activity on clinically relevant bleeding events after percutaneous coronary intervention (2021)
  • Author(s): Nishikawa T, Morishima T, Fujii Y, Okawa S, Otsuka T, Kamada R, Yasui T, Shioyama W, Oka T, Tabuchi T, Fujita M
  • Journal Title: Journal of Medical Investigation Volume: 68 Pages: 29-37
  • Peer Reviewed
• [Journal Article] Validity of claims‐based algorithms for selected cancers in Japan: Results from the VALIDATE‐J study (2021)
  • Author(s): Luise Cynthia、Sugiyama Naonobu、Morishima Toshitaka、Higuchi Takakazu、Katayama Kayoko、Nakamura Sho、Chen Haoqian、Nonnenmacher Edward、Hase Ryota、Jinno Sadao、Kinjo Mitsuyo、Suzuki Daisuke、Tanaka Yoshiya、Setoguchi Soko
  • Journal Title: Pharmacoepidemiology and Drug Safety Volume: in press Pages: in press
  • DOI: 10.1002/pds.5263
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Trends in clinical stage distribution and screening detection of cancer in Osaka, Japan: Stomach, colorectum, lung, breast and cervix (2020)
  • Author(s): Toyoda Yasuhiro、Tabuchi Takahiro、Hama Hitomi、Morishima Toshitaka、Miyashiro Isao
  • Journal Title: PLOS ONE Volume: 15 Pages: e0244644
  • DOI: 10.1371/journal.pone.0244644
  • Peer Reviewed / Open Access
• [Journal Article] Long‐term trends in sex difference in bladder cancer survival 1975‐2009: A population‐based study in Osaka, Japan (2020)
  • Author(s): Aoe Jo、Ito Yuri、Fukui Keisuke、Nakayama Masashi、Morishima Toshitaka、Miyashiro Isao、Sobue Tomotaka、Nakayama Tomio
  • Journal Title: Cancer Medicine Volume: 9 Pages: 7330～7340
  • DOI: 10.1002/cam4.3382
  • Peer Reviewed / Open Access
• [Journal Article] Geriatric assessment domains to predict overall survival in older cancer patients: An analysis of functional status, comorbidities, and nutritional status as prognostic factors (2020)
  • Author(s): Morishima Toshitaka、Sato Akira、Nakata Kayo、Miyashiro Isao
  • Journal Title: Cancer Medicine Volume: 9 Pages: 5839～5850
  • DOI: 10.1002/cam4.3205
  • Peer Reviewed / Open Access
• [Journal Article] Comparison of overall mortality between hysterectomy and concurrent chemoradiotherapy for the primary treatment of localized or regionally extended cervical cancer (2020)
  • Author(s): Shigemi Daisuke、Morishima Toshitaka、Shibata Ayako、Tabuchi Takahiro、Yasunaga Hideo、Miyashiro Isao
  • Journal Title: Annals of Clinical Epidemiology Volume: 2 Pages: 75～83
  • DOI: 10.37737/ace.2.3_75
  • Peer Reviewed
• [Journal Article] Clinical Outcomes of Patients with Adult T Cell Leukemia-Lymphoma in a Nonendemic Metropolitan Area: A Retrospective Analysis of the Population-Based Osaka Cancer Registry (2020)
  • Author(s): Fuji Shigeo、Kida Shuhei、Morishima Toshitaka、Nakata Kayo、Miyashiro Isao、Ishikawa Jun
  • Journal Title: Biology of Blood and Marrow Transplantation Volume: 26 Pages: 1433～1438
  • DOI: 10.1016/j.bbmt.2020.04.019
  • Peer Reviewed
• [Journal Article] がん患者における医療保険の種別・本人家族別にみた検診発見がん及び早期がんの割合 (2020)
  • Author(s): 森島敏隆, 佐藤亮, 中田佳世, 濱秀聡, 田淵貴大, 松本吉史, 小枝伸行, 島田裕子, 丸濱勉, 松木大作, 宮代勲, 大阪府がん診療連携協議会がん登録・情報提供部会
  • Journal Title: 厚生の指標 Volume: 67 Pages: 1月6日
  • Peer Reviewed
• [Journal Article] Oral cavity cancer incidence rates in Osaka, Japan between 2000 and 2014 (2020)
  • Author(s): Koyama Shihoko、Tabuchi Takahiro、Okawa Sumiyo、Morishima Toshitaka、Ishimoto Shunsuke、Ishibashi Miki、Miyashiro Isao
  • Journal Title: Oral Oncology Volume: 105 Pages: 104653
  • DOI: 10.1016/j.oraloncology.2020.104653
  • Peer Reviewed
• [Journal Article] High incidence of head and neck cancers after endoscopic resection for esophageal cancer in younger patients (2020)
  • Author(s): Maekawa A、Ishihara R、Iwatsubo T、Nakagawa K、Ohmori M、Iwagami H、Matsuno K、Inoue S、Arao M、Nakahira H、Matsuura N、Schichijo S、Kanesaka T、Yamamoto S、Takeuchi Y、Higashino K、Uedo N、Fujii T、Morishima T、Miyashiro I
  • Journal Title: Journal of Gastroenterology Volume: 55 Pages: 401～407
  • DOI: 10.1007/s00535-019-01653-y
  • Peer Reviewed
• [Presentation] シンポジウム「多施設DPCデータ活用の実践と今後の展望」臨床疫学研究における限界を突破するための他データとのリンケージの事例 (2020)
  • Author(s): 森島敏隆
  • Organizer: 第79回日本公衆衛生学会総会
  • Invited
• [Presentation] 医療保険の種別・本人家族別に見た検診発見がん及び早期がんの割合 (2020)
  • Author(s): 森島敏隆, 佐藤亮, 中田佳世, 濱秀聡, 田淵貴大, 宮代勲
  • Organizer: 日本がん登録協議会第29回学術集会
• [Presentation] Effect of adjuvant chemotherapy on survival benefit in stage III colon cancer patients stratified by age: a real-world cohort study (2020)
  • Author(s): Kawamura H, Morishima T, Sato A, Honda M, Miyashiro I
  • Organizer: 2020 ASCRS (American Society of Colon and Rectal Surgeons) Annual Scientific Conference Recorded Sessions
  • Int'l Joint Research
• [Presentation] Treatment of advanced non-small cell lung cancer in dialysis patients; findings from Osaka cancer registry data (2020)
  • Author(s): Kida N, Tsubakihara Y, Morishima T, Sato A, Miyashiro I
  • Organizer: The 57th ERA-EDTA (European Renal Association - European Dialysis and Transplant Association) Congress
  • Int'l Joint Research
• [Presentation] Dose reduction in inhaled corticosteroids of sublingual immunotherapy for Japanese cedar pollen-associated allergic rhinitis and asthma (2020)
  • Author(s): Morita K, Morishima T, Yoshimura C, Nishizaka Y
  • Organizer: EAACI (European Academy of Allergy & Clinical Immunology) Congress 2020
  • Int'l Joint Research