JAPAN’S national genomic registry data showed that lung cancer treatment duration was longer at facilities with two or more Japanese Society of Medical Oncology (JSMO) specialists, although the adjusted analysis did not establish a significant association.
The nationwide registry study examined whether facility-level specialist availability was associated with first-line time to treatment failure (TTF) among patients with lung cancer. Researchers linked data from Japan’s Center for Cancer Genomics and Advanced Therapeutics (C-CAT) with facility-level workforce information to investigate whether the availability of oncology specialists could provide an indicator of cancer care infrastructure.
The primary exposure was the number of JSMO specialists available at the treating facility, categorised as 0–1 or ≥2 specialists. A secondary analysis examined the availability of physicians listed by both JSMO and the Japanese Respiratory Society as a more lung-cancer-oriented measure of specialist provision.
The analysis included 5,456 patients treated across 241 facilities. Of these, 1,477 patients were treated at facilities with 0–1 JSMO specialists, while 3,979 were treated at facilities with ≥2 specialists.
Kaplan–Meier analysis found that median first-line TTF was 4.2 months among patients treated at facilities with 0–1 specialists, compared with 5.1 months among those treated at facilities with ≥2 specialists. The difference between groups was statistically significant in the unadjusted analysis (P<0.001).
However, after clinical adjustment and accounting for clustering within facilities, the association was no longer statistically significant. The hazard ratio (HR) for patients treated at facilities with ≥2 specialists compared with 0–1 specialists was 0.911 (95% CI: 0.806–1.029; P=0.133).
Although the point estimate remained in the direction of a longer recorded treatment process, the confidence interval included the possibility of no association.
The findings highlighted the potential value of linking national genomic registry data with facility-level workforce information when examining cancer care delivery. Specialist availability may offer a useful facility-level measure of oncology care infrastructure, but the study did not establish that greater specialist availability led to clinically preferable treatment duration.
Importantly, TTF represented the duration of a recorded treatment process, from systemic therapy initiation until recorded treatment end or death. The measure did not indicate why treatment ended or whether a longer duration represented a better clinical outcome.
Reference
Kajiura S et al. Facility-level medical oncology specialist availability and first-line time to treatment failure in lung cancer: a nationwide C-CAT registry analysis. Curr Oncol. 2026,33(8):462.
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