Inter-prefectural and urban–rural regional disparities in rectal cancer and rectal resections: A Japanese nationwide population-based cohort study from 2014 to 2019

IF 2.9 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Masamitsu Kido, Tomohiro Arita, Katsutoshi Shoda, Hiroki Shimizu, Jun Kiuchi, Kenji Nanishi, Luying Yan, Eigo Otsuji
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Abstract

Aim

This observational study aimed to elucidate the regional disparities in rectal cancer (RC) and rectal resections (RRs) across Japan.

Methods

The annual incidence of RC, and number of all RRs and board-certified surgeons by the Japan Society for Endoscopic Surgery were examined by prefecture in Japan from 2014 to 2019. The surgical approaches were broken down by open and laparoscopic. Disparities in 47 prefectures and urban–rural disparities were evaluated using the Gini coefficient and unpaired t-test.

Results

The annual national average incidence of RC was 50 127 and the number of all RRs was 39 903. Gini coefficients for RC, and laparoscopic and all RRs were <0.2, indicating low inequality. There was no significant difference between urban and rural prefectures in the number of RRs, despite a significantly higher incidence of RC in rural prefectures and a significantly higher number of board-certified surgeons in urban prefectures (p < 0.05).

Conclusion

RC and laparoscopic and all RRs exhibited minimal inter-prefectural disparities. The urban–rural analysis revealed significant differences in the incidence/number of RC and board-certified surgeons between urban and rural prefectures, despite minor differences in RRs regardless of approach. This pattern suggests a potential migration of surgical services from rural to urban areas. This preliminary study is expected to contribute to a basic epidemiological database for RC and RRs.

Abstract Image

直肠癌和直肠切除术的县际和城乡地区差异:2014年至2019年日本全国人口队列研究
目的本观察性研究旨在阐明日本直肠癌(RC)和直肠切除术(rs)的地区差异。方法统计2014 - 2019年日本各县的年度RC发病率、所有rr人数和经日本内镜外科学会认证的外科医生人数。手术入路分为开放入路和腹腔镜入路。采用基尼系数和非配对t检验对47个地级市的差异和城乡差异进行评价。结果全国年平均RC发病率为50 127例,所有rr数为39 903例。RC、腹腔镜和所有rr的基尼系数均为0.2,表明不平等程度较低。尽管农村地区的RRs发生率显著高于城市地区,而城市地区获得委员会认证的外科医生数量显著高于城市地区,但城乡地区的RRs数量无显著差异(p < 0.05)。结论RRs与腹腔镜RRs及所有RRs在地区间差异极小。城乡分析显示,城乡地区之间RC和委员会认证的外科医生的发病率/数量存在显著差异,尽管不同方法的rr差异较小。这种模式表明外科服务可能从农村向城市地区迁移。这项初步研究预计将有助于建立RC和RRs的基本流行病学数据库。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
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