Abstract
The International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer did not take into account any of the findings determined by imaging modalities as part of the staging work-up. However, in the Japanese clinical settings, computed tomography (CT) and magnetic resonance imaging (MRI) are frequently used. In this study, we aimed to describe the pretreatment use of sensitive imaging modalities in Japan in order to assess the future adaptability of the FIGO staging system.Data from September 2012 to December 2014 were collected from the National Database of the Hospital-Based Cancer Registry and health insurance claims data. A total of 280 hospitals participated. From the database, all patients with cervical cancer who received first-line therapy at the participating hospitals were analyzed. The proportions of patients who had CT, MRI, and positron emission tomography-CT (PET-CT) before receiving the first-line therapy were calculated. For comparison, the proportions of patients who had undergone cystoscopy and/or proctoscopy -- examinations that are incorporated into the FIGO system -- were also calculated. A total of 13 668 patients were included; 77.3% of patients had early stage (stage 0 or I) disease. Among all patients, 88.5% had undergone CT, MRI, or PET-CT before receiving the first-line therapy. Additionally, over 90% of patients with advanced-stage (stage II–IV) disease had undergone CT. Conversely, only 21.0% of patients with stage II–IV disease were reported to have undergone cystoscopy and/or proctoscopy. Promoting a resource-stratified approach in the cervical cancer staging is warranted.
Highlights
Cervical cancer is the second most common gynecological malignancy in Japan
The International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer did not take into account any of the findings determined by imaging modalities as part of the staging work-up
We aimed to describe the pretreatment use of sensitive imaging modalities in Japan in order to assess the future adaptability of the FIGO staging system.Data from September 2012 to December 2014 were collected from the National Database of the Hospital-Based Cancer Registry and health insurance claims data
Summary
Cervical cancer is the second most common gynecological malignancy in Japan. In 2010, the age-standardized incidence rate of cervical cancer, including carcinoma in situ, was 52.1 per 100 000, and the mortality rate was 4.1 per 100 000 (National Cancer Center [NCC], 2015). In Japan, like most other countries, the International Federation of Gynecology and Obstetrics (FIGO) staging system is in wide use; it was first established in 1958 and most recently updated in 2009 (Pecorelli, Zigliani, & Odicino, 2009; Pecorelli, 2009). The FIGO staging system of 2009 did not incorporate the findings determined using sensitive imaging modalities such as computed tomography (CT) scans and magnetic resonance imaging (MRI), due to the limited access to such sophisticated imaging equipment in many parts of the world. For this reason, the use of these modalities is encouraged rather as an adjunct examination whenever available. Greater access to these imaging modalities makes the FIGO staging system appear somewhat obsolete, if not gjhs.ccsenet.org
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