Inter-prefectural regional disparities in gastric cancer surgery: A Japanese nationwide population-based cohort study from 2014 to 2019

IF 2.9 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of Gastroenterological Surgery Pub Date : 2024-05-01 DOI:10.1002/ags3.12813

Masamitsu Kido, Katsutoshi Shoda, Luying Yan, Kazuya Ikoma, Daisuke Ichikawa

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Abstract

Aim

This study aimed to investigate the regional disparities in gastric cancer surgery in Japan.

Methods

The annual incidence of gastric cancer and number of gastrectomies, board-certified surgeons in gastroenterology by the Japanese Society of Gastroenterological Surgery, and board-certified surgeons by the Japan Society for Endoscopic Surgery were evaluated by prefecture in Japan during 2014–2019. Medium-sized regional disparities were assessed using the Gini coefficient. Gastrectomies were further broken down by site (distal; proximal; total) and approach (open vs laparoscopic). Moreover, we compared the urban and rural regional disparities in all study variables.

Results

The annual national average incidence of gastric cancer was 127 466 and the number of gastrectomies was 49 128. Gini coefficients for almost all variables, except for board-certified surgeons by the Japan Society of Endoscopic Surgery, were <0.2, indicating low inequality. The incidence of gastric cancer, the number of gastrectomies, and the aging rate were significantly higher in rural prefectures than in urban prefectures.

Conclusion

Inter-prefectural regional disparities in gastric cancer surgery were generally small; however, both the incidence of gastric cancer and number of gastrectomies were higher in rural prefectures, where the aging rate was also increased. This study provides an overview of the landscape of gastric cancer care in Japan.

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胃癌手术的县际地区差异：2014年至2019年日本全国人群队列研究

这项研究旨在调查日本胃癌手术的地区差异。研究人员以日本各都道府县为单位，评估了 2014-2019 年期间的胃癌年发病率和胃切除术数量、日本胃肠外科学会认证的胃肠外科医生以及日本内镜外科学会认证的外科医生。中等规模的地区差异采用基尼系数进行评估。胃切除术按部位（远端、近端、全部）和方法（开腹与腹腔镜）进一步细分。此外，我们还比较了所有研究变量中城市和农村地区的差异。全国年平均胃癌发病率为 127 466 例，胃切除术数量为 49 128 例。除获得日本内镜外科协会认证的外科医生外，几乎所有变量的基尼系数都小于 0.2，表明不平等程度较低。农村都道府县的胃癌发病率、胃切除术数量和老龄化率明显高于城市都道府县。胃癌手术的县际地区差异一般较小；但是，农村都道府县的胃癌发病率和胃切除术数量都较高，老龄化率也较高。本研究提供了日本胃癌治疗的概况。

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