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Subsequent primary cancer incidence in cervical cancer survivors: insights from a comprehensive cohort study utilizing combined Japanese population-based cancer registries
This study aimed to evaluate the incidence of subsequent primary cancer (SPC) among cervical cancer survivors in Japan. Data from the cancer registries of Osaka, Kanagawa, and Miyagi prefectures were combined. The cohort included individuals diagnosed with invasive and in situ cervical cancer between 1980 and 2010, with the SPC incidence evaluated until 2015. The incidence and standardized incidence ratio (SIR) for different SPC sites were calculated. In addition, the association between SPC and radiotherapy was examined via competitive regression analysis. A total of 49,824 cervical cancer survivors were followed for up to 35 years, during which 4,507 (9.0%) of these survivors experienced SPC. Aside from the initial cancer, SPC was the most common cause of death among cervical cancer survivors. The most frequent SPC sites were the colorectal, breast, lung, and stomach, consistent with the frequency in the general population. A significant increase in the SIRs for bladder, lung, and colorectal cancers was observed (2.52, 1.63, and 1.44, respectively). Individuals who underwent radiotherapy had a higher risk of developing bladder cancer than those who did not, with a subdistribution hazard ratio of 2.28. The SIR for lung cancer significantly increased, particularly for the smoking-associated types, indicating the influence of smoking habits among survivors. Increased risk of specific SPCs was seen in both invasive and in situ cancer survivors. Cervical cancer survivors should be informed about the risks of SPCs and educated on the prevention methods. Our study provides valuable insights into specific actions SPC prevention.
Japan Society of Gynecologic Oncology 2023 guidelines for treatment of uterine body neoplasm
The Japan Society of Gynecologic Oncology (JSGO) guideline for the treatment of uterine body neoplasm are revised from the 2018 guideline. This guideline aimed to provide standardized care for uterine body neoplasm, indicate appropriate current treatment methods for uterine body neoplasm, minimize variances in treatment methods among institutions, improve disease prognosis and treatment safety, reduce the economic and psychosomatic burden on patients by promoting the performance of appropriate treatment, and enhance mutual understanding between patients and healthcare professionals. The guidelines were prepared through the consensus of the JSGO guideline committee, based on a careful review of evidence from the literature searches and the medical health insurance system and actual clinical practice situations in Japan. The main features of the 2023 revision are as follows: 1) The Guidelines Formulation Committee members were asked to understand Minds' medical guideline development method in advance. 2) The clinical question (CQ) was changed to Patient, Intervention, Comparison, Outcome format as much as possible. 3) Introduced the "body of evidence," which summarizes the results of research reports collected for the CQs by outcome and study design, and the strength of evidence for each body of evidence was rated from levels A to D. 4) Introduction of systematic reviews in some CQs. 5) The strength of evidence, the balance of benefits and harms, value and hope for patients, and clinical applicability were considered while drafting recommendations. Herein, we present the English version of the JSGO guidelines 2023 for the treatment of uterine body neoplasm.
Awareness and attitude toward cardio‐oncology among Japanese gynecologic oncologists in managing patients with endometrial cancer: The Japanese Gynecologic Oncology Group (JGOG) questionnaire surveys
AbstractAimThis study aimed to assess the awareness of the concept of “cardio‐oncology” and cardiovascular disease (CVD) in patients with endometrial cancer (EC) among the Japanese Gynecologic Oncology Group members.MethodsAn online anonymous survey, which consisted of questions about respondent attributes and cardio‐oncology, was conducted twice, in 2022 and 2024. During these surveys, guidelines for the treatment of uterine body neoplasm were published in July 2023.ResultsIn 2022, significantly numerous physicians were unaware of cardio‐oncology or the increased risk of developing CVD in patients with EC, and 25.3% of them answered that they had no idea about cardio‐oncology at all. However, in 2024, the percentage significantly dropped to 8.7%. The number of physicians who were aware that CVD is more common as the cause of death in patients with low‐grade EC than the cancer itself was significantly higher in 2024 than in 2022. Similarly, the number of physicians who were aware that the usage of platinum agents could become a risk factor for CVD was significantly higher in 2024. Furthermore, this study reported challenges in the collaboration between oncologists and primary care physicians in the region and in the provision of guidance for preventing metabolic syndrome.ConclusionJapanese Gynecologic Oncology Group members' awareness of cardio‐oncology was inadequate, but it seemed to be improving, especially after publishing the guideline for the treatment of uterine body neoplasm. Thus, raising awareness of cardio‐oncology and managing CVD risk in patients with EC are necessary to improve long‐term survival after cancer diagnosis.
