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Inter-prefectural and urban–rural regional disparities in lung cancer surgery: a Japanese nationwide population-based cohort study from 2017 to 2019

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Abstract

Purpose

To investigate regional disparities in lung cancer surgery in Japan.

Methods

The annual incidence of lung cancer, lung cancer surgery, and the number of board-certified thoracic surgeons in Japan during 2014–2019 were investigated using a national open database. Lung cancer surgeries were categorized by procedure (wedge resection, segmentectomy, lobectomy, pneumonectomy) and approach (open, thoracoscopic). Disparities in 47 prefectures and urban–rural disparities during 2017–2019 were evaluated using the Gini coefficient and an unpaired t-test. Correlation was assessed using Pearson’s correlation method.

Results

The national annual average incidences of lung cancer and lung cancer surgery were 121,106 and 50,959, respectively, in 2014–2019. The use of the thoracoscopic approach increased over time in all procedures, except pneumonectomies. The Gini coefficients of lung cancer, thoracoscopic surgery, and board-certified thoracic surgeons indicated low inequality across prefectures; however, those of open surgery indicated high inequality. Open surgery was more common in urban areas than in rural areas. The number of thoracoscopic surgeries and board-certified thoracic surgeons by prefecture were moderately correlated.

Conclusion

The thoracoscopic approach is becoming more common in lung cancer surgery, with little inter-prefectural regional disparity in the incidence of lung cancer, thoracoscopic surgeries, or the number of board-certified thoracic surgeons.

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Acknowledgements

None.

Funding

This study did not receive any specific grants from funding agencies in the public, commercial, or non-profit sectors.

Author information

Author notes

  1. Masamitsu Kido and Satoru Okada contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedic Surgery, Inage Hospital, 6-21-3 Konakadai, Inage-Ku, Chiba, 2630043, Japan

    Masamitsu Kido

  2. Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 6028566, Japan

    Satoru Okada, Atsuki Uchibori & Masayoshi Inoue

  3. Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 6028566, Japan

    Naoyuki Takashima

  4. Department of Anesthesiology, Brigham and Women’s Hospital, 75 Francis St, Boston, MA, 02115, USA

    Luying Yan

  5. Division of Thoracic Surgery, Japan Self-Defense Forces Central Hospital, Tokyo, 1548532, Japan

    Koji Sensaki

  6. Department of Thoracic Surgery, TOHO Yao Hospital, Osaka, 5810802, Japan

    Tetsuo Kido

Authors
  1. Masamitsu Kido
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Correspondence to Satoru Okada.

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This study did not require institutional board approval or informed consent because of its retrospective nature and use of anonymized public data.

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Kido, M., Okada, S., Takashima, N. et al. Inter-prefectural and urban–rural regional disparities in lung cancer surgery: a Japanese nationwide population-based cohort study from 2017 to 2019. Surg Today (2024). https://doi.org/10.1007/s00595-024-02864-4

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