The Hokushin Ganpro Database and health care utilization data
“Hokushin Ganpro” is the name of the educational program implemented by the Ministry of Education, Culture, Sports, Science and Technology of Japan (https://gan-pro.net/) to enable improved cancer treatment by training highly skilled health care professionals via cooperation among the universities in the Hokushin region (Kanazawa University, Kanazawa Medical University, Shinshu University, The University of Toyama, The University of Fukui, and Ishikawa Prefectural Nursing University).
The Hokushin Ganpro Database 2 is a regional cancer database created as one of the projects of the Hokushin Ganpro and built from the hospital-based cancer registry (HBCR) linked health care utilization data, so called Diagnosis Procedure Combination (DPC) survey data. Collection of DPC data was performed part of a governmental survey to assess the effects of the introduction of the diagnosis procedure combination-based payment system. The survey data included information equivalent to fee-for-service insurance claims that cover all billable health services (e.g., diagnostic tests, imaging workup, procedures, treatments, and prescribed drugs) for both inpatients and outpatients. These data were linked to the HBCR data of each patient in the participating hospitals. The Hokushin region has 28 designated cancer care hospitals in which approximately 35000 people are diagnosed with cancer and registered every year. Among them, 20 hospitals and 2 other hospitals participated in Hokushin Ganpro dataset 2 (Supplemental Table 1).
In the present study, the definition of malignancy corresponds to behavioral codes 2 or 3 in the International Classification of Disease for Oncology, 3rd edition (ICD-O-3). All targeted lung cancers newly encountered at hospitals from January 1, 2016, to December 31, 2017, were registered. The interval of corresponding DPC data to HBCR in the Hokushin Ganpro Database was selected from October 1, 2015, to July 31, 2017. We analyzed the patients in Class of Cases 20 and 30. These are coded as 20 (diagnosed and treated initially in the registering hospital) and 30 (diagnosed in another hospital and treated initially in the registering hospital), respectively. The histological types and the codes for lung cancer included small cell lung cancer (codes 80413, 80453), adenocarcinoma (codes 81402, 81403, 81413, 82003, 82113, 82303, 82503, 82523, 82533, 82543, 82553, 82603, 82633, 82653, 83103, 84803, 84813, 85503, 85513), squamous cell carcinoma (codes 80523, 80702, 80703, 80713, 80723, 807433, 80823, 80833), neuroendocrine tumors (codes 80133, 82403, 82463, 82493), large cell carcinoma (codes 80123), adenosquamous cell carcinoma (code 85603), and others (codes 80003, 80013, 80102, 80103, 80203, 80223, 80313, 80323, 80333, 80463, 84303, 85743, 89723).
National data were drawn from the National Cancer Registry [2]. This study was approved by the Institutional Review Board of Shinshu University School of Medicine (No.5054) and Kanazawa University (No.2750-4). Institutional Review Board approval was also obtained from each participating facility for collecting the anonymized data and creating the database. The need for informed consent was waived by the Institutional Review Boards of Shinshu University School of Medicine (No.5054) and Kanazawa University (No.2750-4) due to the retrospective nature of the study and handling anonymized data. The dataset was used with permission from the Data Utilization Committee of Hokushin Ganpro Database Project (Institutional Review Board of Kanazawa University (No.2750-4)).