Background There is significant concern that cancer care is adversely impacted due to the coronavirus disease pandemic. Using the national database, we document the impact of the pandemic on cancer diagnosis in Japan. Methods Data from 735 hospital-based cancer registries, covering >70% of newly diagnosed cases, were analysed. We compared trends during 2016–2019 and those in 2020 by the type of cancer, diagnostic process, stage and 13 prefectures as requiring special precautions to prevent the spread of infection. Results Overall, the number of patients who began treatment decreased by 1.9% in 2020 as compared with the average number during 2016–2019. A sharp decline of 13.8% was observed for stomach cases. The decline in cases (22.0% decrease for all cancers) was more pronounced in May. Cancer screening and resulting detection decreased significantly in 2020 (8.1–24.3%). Case registrations of stage I and II gastric cancer, stage II intrahepatic cholangiocarcinoma, stage II oesophageal cancer, stage 0 and I laryngeal cancer and stage II gallbladder cancer decreased by >10% compared with those in 2018 and 2019. The trends in cancer cases by area of residence indicated a decline in 13 prefectures in May 2020 compared with other areas. Conclusions The number of cancer diagnoses decreased during the year 2020 under coronavirus pandemic, especially right after the Japanese government declared the first state of emergency in April. We need to carefully observe the consequences of these decrease in diagnosis, or perhaps the delay in care, on patient survival or population mortality.

Preventive application of heparinoid moisturizer from the first day of WBRT significantly increased water content and helped to improve skin desquamation and dryness compared with no treatment.

ObjectiveThe effect of heparinoid moisturizer use after acute skin damage for patients receiving whole-breast radiotherapy after lumpectomy is understudied.MethodsA total of 30 patients were randomly assigned to receive heparinoid moisturizer (Group M), and 32 patients comprised the control group (Group C). Patients in Group M were instructed to apply heparinoid moisturizer from 2 weeks following whole-breast radiotherapy, and to continue to use the moisturizer until 3 months after completion of whole-breast radiotherapy. Group C patients were instructed to not apply any topical moisturizer during the study period. The relative ratio of skin water content ratio (RWCR(t) = (It /Nt)/(I0/N0)) between irradiated and non-irradiated field was calculated. Signs and symptoms were also assessed. The primary endpoint was the difference in relative ratio of skin water content ratio between 2 and 4 weeks following whole-breast radiotherapy.ResultsIn Group C, relative ratio of skin water content ratio dropped to 0.80 ± 0.15 at 2 weeks and maintained the low level at 4 weeks following whole-breast radiotherapy. Similarly, in Group M, relative ratio of skin water content ratio dropped to 0.81 ± 0.19 at 2 weeks (prior to application), however, it returned to baseline level (1.05 ± 0.23) at 4 weeks (2 weeks after application). The arithmetic difference of relative ratio of skin water content ratio in Group M was 0.24 ± 0.23 and was significantly larger than in Group C (0.06 ± 0.15; P < 0.01). Skin dryness and desquamation were less severe in Group M.ConclusionsThe application of heparinoid moisturizer for 2 weeks following whole-breast radiotherapy significantly increased water content and helped improve skin dryness and desquamation compared with no use of moisturizer.

Background Hospital-based cancer registries were developed to describe and improve clinical care for cancer patients. We described the hospital-based cancer registry coverage as a reference for the users, including researchers, policymakers and clinicians. Methods The hospital-based cancer registry coverage was defined as the proportion of new cases registered in the hospital-based cancer registry to the National Cancer Registry as the denominator. To examine the coverage of respective cancer types, age groups and prefecture in the hospital-based cancer registry, cases were grouped based on the 10th International Statistical Classification of Diseases and Related Health Problems and were compared with the published report of the National Cancer Registry in 2017. Results The overall hospital-based cancer registries coverage was 71.7%, and 52.5% of patients were treated at designated cancer care hospitals. The hospital-based cancer registries coverage and treatment rates at designated cancer care hospitals varied per cancer type, age group, and prefecture. The hospital-based cancer registries covered over 80% of the patients with cancers of the larynx, uterus, oesophagus, lip, oral cavity, pharynx and skin, whereas patients’ coverage with thyroid cancer was relatively low. The hospital-based cancer registry coverage of young patients (&lt;15 years) was &gt;80%, whereas that for elderly patients (≥85 years) was &lt;55%. The range of coverage in each prefecture was from 43.0 to 89.7%. Over 70% of the patients with cancers of the larynx, lip, oral cavity and pharynx were treated at designated cancer care hospitals. Conclusions The hospital-based cancer registry coverage is ~70% of all cancers. Because the coverage differed across cancers and age groups, the respective target groups’ analysis should consider this factor.

We showed that the proportions of early-stage cancer patients and younger patients are greater in higher-volume hospitals compared with lower-volume hospitals in Japan. Researchers conducting volume-outcome studies and policymakers analyzing hospital performance should be cautious when making interhospital comparisons.