Quality indicators for cervical cancer care in Japan

Tomone Watanabe, Mikio Mikami, Hidetaka Katabuchi, Shingo Kato, Masanori Kaneuchi, Masahiro Takahashi, Hidekatsu Nakai, Satoru Nagase, Hitoshi Niikura, Masaki Mandai, Yasuyuki Hirashima, Hiroyuki Yanai, Wataru Yamagami, Satoru Kamitani, Takahiro Higashi

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Objective: We aimed to propose a set of quality indicators (QIs) based on the clinical guidelines for cervical cancer treatment published by The Japan Society of Gynecologic Oncology, and to assess adherence to standard-of-care as an index of the quality of care for cervical cancer in Japan. Methods: A panel of clinical experts devised the QIs using a modified Delphi method. Adherence to each QI was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2013, and linked with insurance claims data, between October 1, 2012, and December 31, 2014. All patients who received first-line treatment at the participating facility were included. The QI scores were communicated to participating hospitals, and additional data about the reasons for non-adherence were collected. Results: In total, 297 hospitals participated, and the care provided to 15,163 cervical cancer patients was examined using 10 measurable QIs. The adherence rate ranged from 50.0% for ‘cystoscope or proctoscope for stage IVA’ to 98.8% for ‘chemotherapy using platinum for stage IVB’. Despite the variation in care, hospitals reported clinically valid reasons for more than half of the non-adherent cases. Clinically valid reasons accounted for 75%, 90.9%, 73.4%, 44.5%, and 88.1% of presented non-adherent cases respectively. Conclusion: Our study revealed variations in pattern of care as well as an adherence to standards-of-care across Japan. Further assessment of the causes of variation and non-adherence can help identify areas where improvements are needed in patient care.

Original languageEnglish
Article numbere83
JournalJournal of gynecologic oncology
Issue number6
Publication statusPublished - 2018


  • Guideline adherence
  • Practice guideline
  • Quality indicators
  • Standard of care
  • Uterine cervical neoplasms

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology


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