3150 - Questionnaire Survey on Radiotherapy Practice in a Rural Prefecture in Japan: Factors Affecting Indication Rates of Radiotherapy
Presenter(s)
Y. Wada1, A. Anbai2, M. Hashimoto3, M. Toshima4, T. Suzuki5, H. Katou5, Y. Ito6, K. Suzuki4, O. Watanabe7, Y. Sasaki8, K. Ito8, D. Kaneko9, Y. Sugawara10, M. Fukuda11, M. Terui12, M. Hosaka13, and N. Mori1; 1Department of Radiology, Akita University Graduate School of Medicine, Akita, Japan, 2Department of Radiology, Omagari Kosei Medical Center, Omagari, Japan, 3Department of Radiation Oncology, Akita City Hospital, Akita, Japan, 4Department of Radiation Oncology, Akita Kousei Medial Center, Akita, Japan, 5Department of Radiation Oncology, Nakadori General Hospital, Akita, Japan, 6Odate Municipal General Hospital, Odate, Japan, 7Department of Radiation Oncology, Akita Red Cross Hospital, Akita, Japan, 8Department of Radiology, Hiraka General Hospital, Yokote, Japan, 9Department of Radiology, Noshiro Kousei Medical Center, Noshiro, Japan, 10Department of Radiology, Yuri Kumiai General Hospital, Yuri-Honjo, Japan, 11Visiting Nursing Station, Home Hospice Akita, Akita, Japan, 12Central Radiology Division, Akita University Hospital, Akita, Japan, 13Division of Nursing, Akita University Hospital, Akita, Japan
Purpose/Objective(s):
The authors work in a rural prefecture with the highest rates of cancer mortality, aging, and population decline in Japan, which may occur worldwide eventually. The indication rate of radiotherapy (RT) for cancer patients in the prefecture is approximately 20%, which is less than that in America, Europe, and almost the rest of Japan. This survey aimed to reveal the factors affecting the low RT rate in the prefecture, mentioning to efficient RT practice in rural areas.Materials/Methods:
A questionnaire survey was conducted in 138 departments, besides the Radiation Oncology Department, which provided cancer treatment in 12 designated cancer hospitals in the prefecture. Anonymous responses were collected between December 2024 and February 2025. Between the two groups divided with an RT rate of 20%, multivariable regression after univariable logistic regression analysis using the stepwise variable selection method with p-values was performed.Results:
Valid responses were obtained from 59 departments (43%). Of those, there were 35 (59%) and 24 (41%) departments with RT rates = 20% and < 20%, respectively. Multivariate analysis revealed that fewer beds and longer waiting times for definitive RT were associated with low RT rates. Only in univariate analysis, hospitals besides the prefectural capital, not involvement of radiation oncologists in treatment selection, and longer waiting times for palliative RT were associated with low RT rates.Conclusion:
Fewer beds and longer waiting times for definitive RT may affect low RT rates. Furthermore, hospitals besides the prefectural capital, not involvement of radiation oncologists in treatment selection, and longer waiting times for palliative RT may affect low RT rates. Shortening waiting times, collaboration between hospitals in the prefectural capital or with more beds and the other hospitals and involvement of radiation oncologists in treatment selection are needed for efficient RT practice in rural areas. Abstract 3150 - Table 1: Logistic regression analyses to identify factors associated with RT rate (59 departments) *p<0.05; †Stepwise variable selection method using p-values; RT; radiotherapy, 95% CI; 95% confidence interval, ref; reference| RT rate | Univariate | Multivariate† | |||||
| ?20%, n=35 | <20%, n=24 | Odds ratio [95% CI] | p | Odds ratio [95% CI] | p | ||
| Hospital in the prefectural capital | Yes No | 23 12 | 9 15 | 1.00 (ref) 0.31[0.11–0.92] | 0.04* | ||
| Number of beds in hospital | = 450 <450 | 20 15 | 8 16 | 1.00 (ref) 0.38[0.13–1.11] | 0.08 | 1.00 (ref) 0.26[0.07–0.92] | 0.04* |
| Annual new cancer patients | = 100 <100 | 14 21 | 9 15 | 1.00 (ref) 0.90[0.31–2.62] | 0.85 | ||
| Involvement of Radiation oncologist in treatment selection | Yes No | 30 5 | 14 10 | 1.00 (ref) 0.23[0.07–0.81] | 0.02* | ||
| Waiting times for definitive RT | = 1 week >1 week | 17 18 | 2 22 | 1.00 (ref) 0.10[0.02–0.47] | <0.01* | 1.00 (ref) 0.07[0.01–0.40] | <0.01 |
| Waiting times for palliative RT | = 1 week >1 week | 22 13 | 7 17 | 1.00 (ref) 0.24[0.08–0.74] | <0.01* |